Tympanoplasty (Major Surgery to Repair the Middle Ear)
There are two basic procedures to repair an eardrum: A minor surgery called a
Myringoplasty,
and a more complex operation called a Tympanoplasty.
A tympanoplasty is discussed on this page.
Procedure Name:
Reconstructive
operations on the middle ear
ICD-9 Description:
Type II Tympanoplasty
ICD-9 Code Family:
19.52 - 54
Description:
The Type II
Tympanoplasty procedures family describe those
operations to repair various problems of the eardrum
as well as procedures to repair various problems
with the ossicles.
Tympanoplasty Surgical procedure (major surgery
in a hospital)
A tympanoplasty is performed under general anesthesia in
a hospital setting, and lasts 1 - 2 hours.
Photo Courtesy of The Internet Journal of
Otorhinolaryngology
A surgical cut is made behind
the ear, through the mastoid area.
Then the ear is moved forward to expose
the middle ear cavity, the back of
the eardrum and the front edge of the eardrum.
The eardrum is cleaned and the infected
area (if any) is cut away.
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The eardrum is is
pushed back by an instrument so the
surgeon can work on the back
of the eardrum.
The eardrum is cut with a scalpel
around the edges of the eardrum a
little over half the circumference. |
As with a myringotplasty, a piece of tissue from
under the skin, and large enough to cover most
of the hole (a graft), is sometimes taken from
behind the ear and grafted onto the back of the eardrum.
First a foam gel is
inserted into the middle ear cavity to act as a
platform for the graft and to keep the ear drum
as still as possible.
The graft is inserted into the inside of the
eardrum where the edges of the hole are folded
back onto the perforation to close the hole.
The eardrum and graft rest on the foam gel. Surgical glue may be applied to keep the tissue
in place as it heals. After a few weeks the foam
gel is beaks down and is discharged out through
the Eustachian tube.
The following is an
excellent video of a tympanoplasty operation
http://entusa.com/surgery_videos_flash/tympanoplasty-complete/tympanoplasty-1024.htm
The Healing Process
After a Tympanoplasty
Long Term Effects of a Surgical Operation on the Ear Drum
The long term effects of a burst eardrum
and subsequent operations on the ear will be a
function of the size of the hole that was repaired,
and how many times the eardrum has to be worked on
before the hole is completely healed. With any
tissue that heals, there is scar tissue residue;
with any operation on body tissue, there is also
scar tissue residue. Scar tissue is the natural
end-result of a successfully healed eardrum.
The eardrum's purpose is to vibrate. the
buildup of scar tissue inhibits that vibration
function; the greater the scar tissue, the less the
eardrum will vibrate, affecting the ability to hear.
As a rule of thumb, a hole in the eardrum that heals
on its own within a few weeks or months will have
minimal effect on hearing. A myringotomy should only
affect hearing loss to a maximum of 5%; a
tympanoplasty can affect hearing negatively up to
20%. Then again if the surgeon does an
excellent job with a tympanoplasty and the hole is
relatively small, hearing loss will be negligible.
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