Tympanoplasty

GENERAL BACKGROUND

The eardrum, or tympanic membrane, is located deep within the ear canal. It can sometimes develop a hole in it, known as a tympanic membrane perforation. Causes of tympanic membrane perforations include trauma, either directly from objects like Q tips, or indirect, such as concussive forces from a slap to ear, and infection. The tympanic membrane helps amplify sound, and any defects in it can cause a decrease in hearing. Repairing the defect requires the placement of thick graft tissue, known as fascia, which is usually harvested from behind the ear.

THE PROCEDURE

The procedure for tympanoplasty in Seattle takes place under general anesthesia or IV sedation administered by our MD Anesthesiologist and takes approximately one to two hours. This is done either by itself or in conjunction with other procedures including mastoidectomy and ossicular chain reconstruction. The procedure is typically done from within the ear canal, but in cases when the canal is narrow, an incision is made behind the ear to access the ear canal. The tympanic membrane is carefully elevated from the surrounding canal, and the fascia graft is placed in the hole. This graft is harvested from muscle located behind the ear. The graft is held in place by a supporting layer of absorbable gelatin sponges placed in the middle ear and on top of the graft.

AFTER SURGERY

There are several risks associated with ossiculoplasty (and ear surgery in Seattle WA). Though the success rate of surgery is high (>90%), there is a risk of unchanged hearing or worsened hearing due to ossicle or prosthesis movement.* If this occurs, revision surgery may be necessary. In cases where the tympanic membrane is intact, there is small risk of a perforation developing in the eardrum as a consequence of the operation. If this occurs, an adjunctive procedure may be necessary. Another risk is alteration in taste. This can occur because the nerve which is responsible for taste on that side of the tongue runs on the undersurface of the tympanic membrane and may be damaged from the perforation. The taste loss is usually temporary and typically recovers after several weeks. Another risk is some unsteadiness following the surgery, which may last up to six months; in rare cases it is a permanent condition. Damage to the facial nerve, which controls movement on that side of the face, is a very slight risk of this surgery. This can result in facial weakness; when this occurs, it is usually temporary and typically recovers after several weeks, but occasionally can be long lasting. The incidence of postoperative infection is less than 5%.* Infections are usually successfully treated with antibiotics. Postoperative bleeding can usually be controlled by packing or a tight dressing but, occasionally, a second operation is required. If you have any questions about this procedure we would love for you to contact us here.

RISKS OF SURGERY

There are several risks associated with tympanoplasty in Seattle. Though the success rate of surgery is high (>90%), there is a risk of failure with the persistence of the hole in the eardrum. If this occurs, revision surgery may be necessary. Another risk is an alteration in taste. This can occur because the nerve which is responsible for taste on that side of the tongue runs on the undersurface of the tympanic membrane and may be damaged from the perforation. The taste loss is usually temporary and typically recovers after several weeks. Another risk is some unsteadiness following the surgery, which may last up to six months; in rare cases, it is a long lasting condition. On rare occasions, the hearing may worsen after surgery and may require possible adjunctive procedures to correct it. Damage to the facial nerve, which controls movement on that side of the face, is a very slight risk of this surgery. This can result in facial weakness; when this occurs, it is usually temporary and typically recovers after several weeks, but occasionally can be permanent. The incidence of postoperative infection is less than 5%. Infections are usually successfully treated with antibiotics. Postoperative bleeding can usually be controlled by packing or a tight dressing but, occasionally, a second operation is required.

Tympanoplasty is an ear surgery procedure. We perform various ear surgeries at our practice including Stapedectomy and Mastoidectomy.