Tympanoplasty

(Middle Ear Repair)
Pronounced: tim-PAN-oh-plas-tee

Definition

Tympanoplasty is a microsurgical procedure on the eardrum and middle ear bones to restore the middle ear hearing mechanism.

The Middle Ear

Tympanoplasty

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Types of tympanoplasty include:

  • Myringoplasty—repair of a tear in the eardrum
  • Tympanoplasty with ossiculoplasty—repair of a tear in the eardrum and correction of a defect in the bones (ossicles) of the middle ear
  • Tympanoplasty with mastoidectomy—repair of a tear in the eardrum and eradication of bony infection in the area behind the ear

Parts of the Body Involved

Ear

Reasons for Procedure

Tympanoplasty is usually done to repair a tear in the eardrum and the ossicles of the middle ear.

The procedure can also help to:

  • Restore hearing and treat certain types of deafness
  • Prevent infection of the middle ear

This factsheet will focus on the repair of eardrum tears.

Risk Factors for Complications During the Procedure

  • Large tears
  • Failure to restore hearing
  • Chronic middle ear disease that may require mastoidectomy to be performed at the same time

What to Expect Prior to Procedure

Before surgery, your doctor will check to be sure that you do not have an ear infection. You will have several tests including an ear exam and a hearing test. At times a CT scan is done to check for any ear infections

In the days leading up to the procedure:

Do not take aspirin or other anti-inflammatory drugs for one week before surgery, unless told otherwise by your doctor. You may also need to stop taking blood-thinning medications. Examples include clopidogrel (Plavix), warfarin (Coumadin), or ticlopidine (Ticlid). Talk to your doctor.

During Procedure

You will be given anesthesia.

Anesthesia

The procedure typically only requires local anesthesia.

Description of the Procedure

A small incision is made behind the ear to reach tissue from the temporalis muscle fascia. This tissue is grafted to the eardrum to cover the hole. Other materials may be added to hold the graft in place. If the bones of the middle ear need to be repaired, this is done as well. A small pack may be left in position in the ear canal, and removed a few days after surgery. Stitches will be left behind the ear for a week, and then removed.

How Long Will It Take?

1-2 hours (sometimes longer if mastoidectomy or ossicular reconstruction needs to be done)

Will It Hurt?

Anesthesia prevents pain during the procedure.

Possible Complications

The risks associated with tympanoplasty are fairly rare, and include:

  • Infection that develops and spreads to inner ear, causing hearing loss and dizziness
  • Infection that develops and spreads beyond the ear causing serious symptoms (rare)
  • Damage to structures in or near the middle ear:
    Nerves—loss or distortion of taste, paralysis of the face
    Middle ear bones—loss of hearing that may require further surgery

Average Hospital Stay

Tympanoplasty is usually done on an outpatient basis. However, if your surgery includes bone repair (ossiculoplasty), you may stay overnight in the hospital.

Postoperative Care

To insure proper healing, avoid the following:

  • Blowing your nose hard.
  • Sneezing.
  • Exposing your ear to water. Ask your doctor how to wash your hair and shower for the first few weeks after surgery.
  • Flying
  • Heavy weight lifting and straining
  • Working out

After the procedure, be sure to follow your doctor’s instructions

Outcome

It will take several weeks after surgery to determine if the tympanoplasty was a success. Complete recovery takes about four weeks.

Call Your Doctor if any of the following occurs:

  • Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
  • Increasing fluid draining from the ear
  • Odor from fluid draining from the ear
  • Dizziness
  • Signs of infection, including fever and chills

Resources

American Academy of Otolaryngology–Head and Neck Surgery, Inc.: entnet.org
National Institute on Deafness and Other Communication Disorders, NIH: nidcd.nih.gov

Canadian Resources:

Canadian Society of Otolaryngology: www.entcanada.org
Health Canada: www.hc-sc.gc.ca

References

American Academy of Otolaryngology–Head and Neck Surgery, Inc. website. Available at: entnet.org.

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