Timpanoplasty

Eardrum repair refers to one or more surgical procedures performed to repair a tear or other damage to the eardrum (tympanic membrane).

Osiculoplasty is the repair of small bones in the middle ear.

The tympanic membrane (eardrum) separates the outer ear from the middle ear. The membrane vibrates when sound waves hit it, initiating the process that converts the sound wave into a nerve impulse to the brain.

Eardrum Repair

Definition
Most adults (and all children) receive general anesthesia. This means you will be asleep and cannot feel the pain. Sometimes, local anesthesia is used together with drugs that make you sleepy.
The surgeon will make an incision behind the ear or inside the ear canal.

Depending on the problem, the surgeon:

It removes any infection or dead tissue in the eardrum or middle ear.
Patches the eardrum (called tympanoplasty) with the patient’s own tissue taken from the vessel or muscle sheath. This process usually takes 2 to 3 hours.
Removes, replaces or repairs 1 or more of 3 small bones in the middle ear (called ossiculoplasty).
It repairs smaller holes in the eardrum by placing gel or special paper over the eardrum (called myringoplasty). This procedure usually takes 10 to 30 minutes.

The surgeon will use an operating microscope to view and repair the eardrum or small bones.

Why is the eardrum repair done?

The eardrum is between the outer ear and the middle ear. It vibrates when sound waves hit it. When the eardrum is damaged or has a hole in it, hearing may decrease and ear infections may be more likely.

Causes of holes or openings in the eardrum include:

• A bad ear infection
• Dysfunction of the eustachian tube
• Sticking something inside the ear canal
• Ear tube placement surgery
• Trauma

If there is a small hole in the eardrum, myringoplasty may work to close it. Most of the time, your doctor will wait at least 6 weeks after the hole before recommending surgery.

Tympanoplasty can be done in the following situations:

• If the eardrum has a larger hole or opening
• If you have a chronic infection in the ear and antibiotics are not helping
• If there is a buildup of extra tissue around or behind the eardrum
• The same problems can also damage the very small bones (ossicles) located just behind the eardrum. If this happens, your surgeon may perform an ossiculoplasty.

Risks
Risks for anesthesia and surgery in general include:

Reactions to drugs
Respiratory Problems
bleeding, blood clots, infection
Risks for Eardrum Repair include:
Damage to the facial nerve or nerve that controls the sense of taste
Damages the small bones in the middle ear, causing hearing loss
dizziness or vertigo
Incomplete healing of the hole in the eardrum
Worsening of hearing or, in rare cases, complete hearing loss
Before Eardrum Repair Surgery
Your doctor will ask:

What allergies might you or your child have to any medication, latex, tape or skin cleanser?

Medicines you or your child use, including herbs and vitamins you buy without a prescription
Surgery day for children:
Follow instructions not to eat or drink. For babies, this includes breastfeeding.
Take the necessary medication with a small sip of water.
If you or your child is sick the morning of the surgery, call the surgeon right away. The procedure will need to be rescheduled.
Arrive at the hospital on time.

After Eardrum Repair Surgery

You or your child can leave the hospital the same day as the surgery, but you may need to spend the night in case of any complications.

To protect the ear after Eardrum Repair Surgery:
A tampon is placed in the ear for the first 5-7 days.
Sometimes a dressing closes the ear itself.
Until your provider says it’s okay:
Do not allow water to enter the ear. While taking a shower or washing your hair, place a cotton ball on the outside of your ear and cover it with Vaseline. Or you can wear a shower cap.
Do not “pop” your ears or blow your nose. If you need to sneeze, do so with your mouth. Pull the mucus from your nose back into your throat.
Avoid air travel and swimming.

Gently wipe the ear drainage from the outside of the ear. You can get ear drops in the first week. Do not put anything else in the ear.

If there are stitches behind the ear and it gets wet, gently pat the area dry. Don’t rub.

You or your child may feel a pulsating or hear popping, clicking, or other sounds in the ear. The ear may feel as if it is full or filled with fluid. There may be sharp, feverish pains immediately after surgery.

To avoid catching a cold, stay away from crowded places and people with cold symptoms.

Outlook (Prognosis)

In most cases, the pain and symptoms are completely relieved. Hearing loss is insignificant.

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