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TYMPANOPLASTY

When a perforation occurs in the eardrum, the water escaping into the ear causes the ear to flow due to the infection. These discharges cause permanent damage to the hearing by causing melting in the bones that provide hearing. The eardrum is a tissue that increases hearing by 15-20 decibels. If there is a perforation, hearing is reduced. The perforated eardrum creates an infection when it interacts with water. This infection also causes permanent hearing damage in the patient. Infections such as facial paralysis, meningitis, dizziness, brain abscess, ear abscess may occur.

Tympanoplasty is an operation to repair the eardrum by removing the inflammation in the middle ear and bone of the patients with a perforation in the eardrum or chronic otitis media. If there is no inflammation, the repair of the eardrum is called myringoplasty.

WHAT IS TYMPANAPLASTY?

Tympanoplasty surgery is technically the repair of the eardrum and the auditory system in the middle ear, and the removal of inflammation in the mastoid bone in the middle ear and behind the ear.

Depending on the extent of the disease detected in the patient, the operation can be performed only by repairing the perforation in the eardrum (myringoplasty) and repairing the ossicular system in the middle ear with membrane repair (tympanoplasty), removing the inflammation that has progressed into the mastoid bone (mastoidectomy), or it is performed a combination of these surgeries (thymoanomastoidectomy).

In tympanoplasty surgery, the ossicles that provide sound transmission are repaired with auxiliary operations by closing the perforation in the eardrum. Necessary tissue, cartilage, bone fragments, or artificial prostheses created for the middle ear are used.

WHAT ARE THE REASONS OF A PERFORATED EARDRUM ?

The eardrum is a thin membrane inside the ear canal that separates the outer ear and middle ear. Perforation of the eardrum occurs as a result of rupture or perforation of this membrane. A perforation in the eardrum causes hearing loss, and sometimes a discharge from the ear occurs. Sometimes, a buzzing and ringing sound may be felt in the ears due to the rupture. This does not cause pain. In some cases, tears and perforations in your ears can close on their own, but in severe cases, surgery is required.

Various activities we may encounter in our daily life can cause changing pressure in the ear to rupture the membrane. This condition, known as barotrauma, is because the pressure inside the ear is different from the outside.

We can list the situations that can cause perforation of the eardrum as follows:

  • Scuba diving
  • Airplane trip
  • Exposure to shock waves
  • Driving at high altitudes
  • Injury and trauma
  • Sudden pressure changes
  • Insertion of foreign objects into the ear
  • titis media
  • Getting hot or acidic liquids into the ear canals
  • Car accidents
  • Sports injuries
  • Falling on the ear
  • A hard blow to the ear
  • Explosion near the ear
Timpanoplasti | Levent Aydar
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WHAT ARE THE SYMPTOMS?

We can list the symptoms of eardrum perforation as follows:

  • Sudden and sharp ear pain in the ear,
  • Bloody, clear or pus-like discharge from the ear,
  • Ringing or buzzing in the ear,
  • Onset of hearing loss,
  • Dizziness.
DIAGNOSIS

If you have heavy discharge from the ear, your doctor will first clean your ear canal. After this procedure, the patient goes through two separate examinations.

  • Endoscope examination: The inside of the ear is looked at with a lighted surgical instrument called an otoscope. If there is a perforation or tear in the ear, this can be observed with headphones during the examination.
  • Audiometry test: The patient applying with the stated complaints is directed to the audiometry test, which measures hearing, with the guidance of the doctor. In this test, the patient listens to the sounds of different frequencies with the help of headphones and presses the button in his hand every time he hears the sounds.
DAMAGES

The eardrum has two roles. One of them is hearing. In the hearing, the eardrum vibrates when sound waves strike. The middle and inner ears convert sound waves into signals. The auditory nerves transmit this signal to the brain and perform hearing. Its second role is protection. The eardrum is a tissue that protects the middle ear from water, bacteria, and other substances.

The closure of the perforation in the eardrum occurs spontaneously in many people. If there is no serious infection or hearing loss, the membrane can be closed without surgery. However, the risk of infection is high in patients who do not receive a doctor's opinion from the onset of symptoms, and permanent hearing loss may occur. For this reason, in case of a rupture of the eardrum, the patient should be directed to the doctor. After examining, the doctor will recommend painkillers, antibiotics, or surgery depending on the situation.

HOW IS THE SURGERY ?

Tympanoplasty is the process of repairing the eardrum and auditory system by removing the inflammation in the middle ear and ear bone. This surgery is applied in chronic middle ear infections and repair of eardrum ruptures due to ear trauma.

Before the operation, the patient is taken the hearing test. Data about the hearing status of the ear and the internal structure of the ear bone are collected by taking tomography. The surgery is performed by taking into consideration of the patient's condition and usually by making an incision behind the ear. When there are diseased tissues in the ear bone, the inside of the ear bone is cleaned. This procedure is called a “mastoidectomy”.

Tympanoplasty surgery is performed painlessly with general anesthesia. The duration of the surgery takes between 1 and 3 hours, depending on the procedure to be performed in the surgery. The perforation in the eardrum is repaired by making use of tissues such as muscle sheath and cartilage around the ear. Severe pain is not observed after the surgery. Simple painkillers will be sufficient for the pain. After the tympanoplasty surgery, antibiotic treatment for a week and ear dressing are performed as often as your doctor approves. After the operation, it is necessary to protect the ear from water for at least 1 month.

Timpanoplasti | Levent Aydar
WHAT TO CONSIDER AFTER THE SURGERY ?

You are usually discharged the day after your tympanoplasty surgery after your dressing is done. The points you should pay attention to after the operation are as follows;

  • To protect your ear from infection after surgery, you should stay away from water for a while.
  • You should regularly use the antibiotic and cortisone-containing drops given by your doctor.
  • It is not recommended to travel by plane in the first month.
  • You should protect your ear from every impact.
  • It is recommended to sleep by elevating your pillow for the first week after the operation. (To reduce blood pressure and edema in the middle ear and behind the ear).
  • Since constipation can adversely affect the ears due to straining, prevent it by consuming fibrous foods and drinking plenty of water.
  • You should not do sports such as diving, swimming, and water skiing for 8 weeks after the operation. Avoid heavy exercises.
  • The tampons in the external ear canal should be replaced by the doctor. Do not remove tampons without consulting a doctor.