What is tympanoplasty?
“Tympanoplasty an, which is applied in chronic middle ear problems, is technically cleaning the inflammation in the middle ear and mastoid bone and repairing the eardrum and middle ear hearing system.
According to the size of the disease, the surgery only involves repairing the hole in the eardrum (myringoplasty), repairing the ossicular system that provides sound conduction in the middle ear (tympanoplasty), clearing advanced inflammation into the mastoid bone (mastoidectomy) or a combination of these operations (tympanomastoidectomy). .
When is the tympanoplasty surgery performed?
In cases where the problem is limited to the hole in the eardrum, if the inflammation is not observed only by protecting the ear from the water, if there is no significant hearing loss and there is no decrease in hearing, surgery to close this hole will eliminate the necessity of protecting the ear from the water and increase the quality of life of the patient and prevent the loss of hearing. and is made according to the patient’s preference.
It is a medical necessity to close the perforation in order to improve the quality of life and prevent the progression of hearing loss and the formation of inflammation-related complications in case of recurrent ear currents, although the ear which is the hole in the membrane is protected from water and there is no focus of infection in the nose and sinus area. If it is not possible to correct the ossicular problems in the same operation in patients with significant hearing loss, if possible, the sound conduction system should be repaired by using various surgical techniques, cartilage, bone grafts or middle ear prostheses.
In the case of inflammatory tissue called cholesteatoma in the middle ear and mastoid bone that progresses by dissolving the bone, this inflammation should be removed as soon as possible with surgery. Maintaining or repairing the auditory system is the second priority in patients with cholesteatoma and the main goal is to clear the inflammation without allowing the possibility of facial paralysis, inner ear hearing loss or intracranial complications (meningitis, brain abscess, etc.).
When deciding the technique of the surgery, the condition of the disease, the location of the hole on the membrane, the structure of the ear canal, whether or not the mastoid bone is intervened during the operation, the preferences of the surgeon and finally the patient are effective.
Although many different surgical techniques are applied under the microscope in the middle ear and mastoid bone during surgery, the patient and his relatives are often limited to the incision in the skin that they can see about the surgery.
Tympanoplasty can be performed through incisions in the ear canal, through the ear or behind the ear. Surgery can be performed through the ear canal only to repair a small hole in the membrane, while the middle and back holes of the membrane are cut through the ear, in the holes in the anterior part of the membrane, and behind the ear incision is preferred in cases where mastoid bone is required. The surgeon’s choice in this regard is the main decision-making factor.
The most commonly used tissue for the repair of the tympanic membrane is the sheath of the temporal muscle. This tissue is easily available during surgery because it is close to the surgical site. The membrane of the cartilage in front of the ear canal or ready-made materials (materials such as suitably treated, sterile parts of the brain) can also be used.
When a repair is needed to ensure the transmission of sound due to damage to the ossicular ossicles, prosthesis made of various materials, parts obtained from the cartilage in front of the ear canal, and many different materials such as the middle ear ossicles can be used in different positions and shapes.
Patients can be discharged from the hospital by dressing on the first postoperative day.
In non-mastoid surgery, special sponges in the ear are usually cleaned at the end of 15-20 days and it is recommended that patients use ear drops containing antibiotics and cortisone to protect their ears from water and to prevent infections and reactions in the operation area. Recovery in this group is completed within 3-4 weeks. In general, the first month should be protected from influenza infections, impacts, air travel should not be. The technical and functional success rate of these patients is generally quite good provided that it depends on the size of the pathology and preoperative hearing level.