What is Tympanoplasty ?
BDS (Bachelor of Dental Surgery), 10 years of experience
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What is the meaning of Tympanoplasty?
Tympanoplasty is a surgical procedure to fix a large or small hole or tear in the eardrum. Tympanoplasty also treats chronic ear infections that cannot be cured with antibiotics.
The tympanoplasty procedure not only closes the perforated eardrum but also helps in improving hearing. Let us explain to you in detail about tympanoplasty through today’s article.
- What is the purpose of Tympanoplasty?
- What are the symptoms for Tympanoplasty ?
- What are the diagnostic tests done before Tympanoplasty?
- How to prepare before Tympanoplasty?
- What is the procedure for Tympanoplasty?
- How to take care after Tympanoplasty?
- What are the risks of Tympanoplasty?
- What is the cost of Tympanoplasty in India?
What is the purpose of Tympanoplasty?
Tympanoplasty is required in cases of a perforated eardrum (called the tympanic membrane) that fails to close on its own.
Damage to the eardrum can affect the hearing ability and requires tympanoplasty.
The eardrum can be perforated in the following cases:
- Otitis media: The infection of the middle ear due to the accumulation of fluid is called otitis media. ( Know more about- Itchy Ear Causes, Symptoms, Treatment and Prevention )
- Barotrauma: Difference in air pressure between the middle ear and outer ear and excessive strain on the eardrum leads to a condition known as barotrauma.
- Explosion or crash: A crash or an explosion causing a very loud noise can damage the eardrum.
- Puncturing of the eardrum: An injury caused by puncturing the eardrum with a sharp object or a cotton swab.
- Severe head injury: An injury to the head may also injure the eardrum.
- Other infections: Some infections may lead to the bursting of the eardrums.
- Cholesteatoma: When there is a growth inside or behind the eardrum leading to the perforation and damage of the eardrum, the condition is known as cholesteatoma.
What are the symptoms for Tympanoplasty?
In many cases, the eardrum can repair itself. However, some cases may require tympanoplasty surgery.
The following symptoms may be seen in case of eardrum damage that may require tympanoplasty surgery:
- Pain in the ear (Know more about- What is Glaucoma Surgery? Causes, Tests and Procedure)
- Bleeding from the ear
- Fluid leakage and discharge from the ear
- Ringing in the ear
- Vertigo ( Know more about- What is Vertigo? Causes, Symptoms, and Treatment)
- Nausea and vomiting
What are the diagnostic tests done before Tympanoplasty?
The ENT specialist will first physically examine the patient. The eardrum is carefully examined. The doctor will then take the complete medical history of the patient.
The doctor recommends the following diagnostic tests before undergoing tympanoplasty:
- Laboratory tests: In case of discharge from the ear, the doctor may advise a laboratory test or culture that can be examined under a microscope to detect bacterial infection.
- Tuning fork examination: This procedure is done using two-pronged metal instruments called tuning forks that produce sound when struck. This procedure is done to evaluate hearing loss and also to ascertain which part of the ear is damaged – the inner ear or middle ear.
- Tympanometry: A tympanometer is a device that helps observe the response of the eardrum to air pressure changes. Also, this test can detect abnormalities in the functioning of the middle ear.
- Audiology examination: It is a procedure conducted to assess hearing loss. The test is done in a soundproof room and includes a number of calibrated tests that help in measuring how well one can hear sounds at different volumes and pitches.
How to prepare for Tympanoplasty?
- The patient should inform the doctor of any medications or supplements he may be taking.
- If the patient is taking any blood-thinning medications like aspirin or warfarin the surgeon will instruct the patient to stop the medications a few days before the surgery, as these medicines increase the risk of bleeding.
- The patient is instructed to not eat or drink anything after midnight the day before the surgery.
- The patient is instructed to quit smoking at least two weeks before the surgery.
What is the procedure for Tympanoplasty?
- The patient is first administered general anesthesia so that he remains unconscious during the procedure.
- The surgeon will first make a cut (incision) behind the ear to reach the ear canal or work through the ear canal directly.
- A laser or micro hook is then used to remove the excess tissue or scar tissue that has built up in the middle ear to gain full access to the tear in the eardrum.
- A small piece of tissue is then taken from the skin behind the ear, or from an ear lobe and is grafted onto the eardrum.
- It is then joined together to repair the hole and its proper functioning is ensured.
- The incision in the ear is then closed with sutures.
- It takes about 30 minutes to 2 hours to complete this procedure.
- Along with tympanoplasty, a procedure called ossiculoplasty can also be performed. This is a procedure in which the bones are restructured to eliminate the gap between the lost ossicles (bones of the middle ear).
- Laser Assisted Tympanoplasty– In this type of treatments, infrared lasers such as CO2 are used for the precision cutting of the tissues near the hole to repair. The CO2 laser is absorbed by the tympanic membrane, which does not damage the middle ear. This has better prognosis, perforation closure rate is 91% and hearing improvement rate is 66%.
How to take care after Tympanoplasty?
- The patient may require at least one week of rest after tympanoplasty.
- The doctor gives ear packs (cotton packing covered with a bandage) to the patient post-surgery. The cotton of the ear pack should be changed regularly to maintain hygiene. This packing stays in the ear for five to seven days after the surgery.
- Ear drops prescribed by the doctor post-surgery should be applied by gently removing the packing, putting the ear drops, and then replacing the packing.
- Playing and swimming in water should be avoided after ear surgery, as water may enter the ears.
- The doctor recommends wearing a shower cap during bathing.
- One should avoid blowing of nose or popping of ears.
- If the patient feels like sneezing, it should be done keeping the mouth open so that there is no pressure build-up in the ears.
- It is best to avoid crowded places and go near people who may be sick as catching a cold after the surgery may increase the chances of getting an ear infection. ( Know more about- What are Tonsil Stones? Causes, Symptoms and Treatments)
- After ear repair, the patient is advised to avoid going to a high altitude, air travel, or go scuba diving so that there is no pressure in the ears.
- It is normal to feel a shooting pain or have a feeling that some liquid has been filled in the ear post-surgery. One may also hear a clicking, popping, or other sounds in the ear. These are mild symptoms seen after the surgery and usually improve after a few days. If the symptoms get worse or do not improve with time contact your doctor immediately.
What are the risks of Tympanoplasty?
There are some risks associated with any type of surgery. Likewise, the risks associated with tympanoplasty are:
- Moderate or severe loss of hearing
- Damage to the facial nerves near the ear or the nerve controlling the sense of taste
- Ringing sound in the ear
- A feeling of fullness in the ear
- Mild ear pain
- Blood of fluid draining out of the ear
- Dizziness. ( Know more about- What is Dizziness? Home Remedies of Dizziness )
- Incomplete or improper healing of the hole in the eardrum
- Damage to the ear ossicles (bones of the middle ear) causing hearing loss
- Abnormal growth of body skin behind the eardrum (called cholesteatoma)
What is the cost of Tympanoplasty in India?
The total cost of tympanoplasty in India can range from around INR 1,50,000 to INR 1,70,000. However, many prominent hospital doctors in India specialize in tympanoplasty. But the cost varies across different hospitals.
If you are coming from abroad, apart from the cost of tympanoplasty surgery, there will be an additional cost of living in a hotel and the cost of local travel. After surgery, the patient is kept for 2-3 days in the hospital and for a few days in the hotel for recovery. So, the total cost of tympanoplasty in India comes to be around INR 2,00,000 to INR 2,30,000.
We hope we have answered all your questions about Tympanoplasty through this article.
For more information and treatment of Tympanoplasty, you can contact the ENT surgeon.
We only aim to give you information through the article. We do not recommend medication or treatment in any way. Only a doctor can give you good advice and the best treatment plan.