Tympanoplasty - Perforated Eardrum Surgery

Ear, Nose And Throat Disorders

Tympanoplasty refers to the surgical procedure for reconstructing a perforated or severely damaged tympanic membrane (eardrum). Sometimes this procedure also includes reconstructing the ossicles; the bones behind the ear drum that conduct sound into the inner ear. The tympanic membrane of the ear is a three-layer structure. The outer and inner layers consist of epithelium cells, while the middle layer is tough fibrous tissue. Perforations occur as a result of defects in the middle layer, which weaken the drum. Small sudden perforations usually heal quickly. However, if the tear is large, if there is poor blood supply, or if infection is present during the healing process, then the repair may be incomplete leaving a permanent hole. In such cases a tympanoplasty may be recommended.

During Tympanoplasty, a hole in the eardrum is patched using material (cartilage) that replaces the missing portion of the eardrum. The cartilage is usually taken from the outer part of the ear or other connective tissue, called fascia, and removed from underneath the skin. During the surgery, the eardrum is lifted and the material used to repair the hole is slipped behind the eardrum. The eardrum is then returned to the original position and the hole is patched from behind. The graft material is supported with packing material, which slowly dissolves. Sometimes a tympanoplasty can be performed completely through the ear canal without the need for an incision in the back of the ear. However, small ear canals, or holes that are very large or situated in a difficult location may require a larger incision made behind the ear.

Risks of Tympanoplasty include: bleeding, infection, hearing loss, graft failure, graft movement, temporary or permanent dizziness, persistent tympanic membrane perforation, altered taste sensation, and need for further surgery.

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