Do you have a constant ringing in your ear? Or do you feel like you've lost a little bit of hearing? Sometimes, something gets stuck in your ear, or you get an ear infection, and your eardrum can become perforated. Don't worry, this happens to many people. One treatment for this is the surgery we're going to talk about today, called Tympanoplasty.
Simply put, what is Tympanoplasty?
Okay, let's put it this way. Your ear has a thin membrane called the eardrum . It's like a leather band that beats a drum. When sound waves from outside hit this eardrum, it vibrates. That vibration is what causes us to hear sounds. Now imagine, what happens if there's a hole in this eardrum? Just like a perforated eardrum doesn't allow sound to be heard properly, when there's a hole in the eardrum, it doesn't vibrate properly. That can cause hearing loss .
Tympanoplasty is a surgical procedure to repair a perforated eardrum. To be precise, it involves putting a small 'patch' over the hole in the eardrum and closing it.
Who should have this surgery?
Small perforations usually heal on their own within two to three months with ear drops or antibiotics. However, if they do not, your doctor may recommend surgery for you or your child. If the perforation persists, it can lead to further hearing loss, frequent ear infections, and fluid drainage.
This surgery is performed by an ear, nose, and throat specialist. We call these doctors an Otolaryngologist (ENT) . Although this is a major surgery, most of the time you can go home the same evening.
How do you prepare before surgery?
When you see your doctor before surgery, he will review your complete medical history and then examine your ear thoroughly.
- Examination with an otoscope: This is a small torch-like instrument that allows the doctor to clearly see how big the hole in the eardrum is, where it is, whether it is infected, or if there is fluid leaking.
- Special tests: You may also have a hearing test to check your hearing level and a test to check how your eardrum is functioning.
In addition, the doctor will explain to you how the surgery will take place and how you should prepare. For example:
- It's time to stop eating and drinking.
- Medications to take and stop before surgery.
- How you may need someone to help you after surgery (especially someone to drive you home).
What happens during surgery?
First, you will be given general anesthesia, so you won't feel anything and will be completely asleep. You may also be given antibiotics to reduce the risk of infection.
After you lose consciousness, the ENT doctor will begin the process of repairing the eardrum. There are several methods for this.
| Surgical method | Simply put... |
|---|---|
| Transcanal | This is the most commonly used method. The surgery is performed by inserting small instruments through the ear canal. No incision is made on the outside. |
| Postauricular | The surgery is performed through a small incision behind the ear, where the earlobe attaches. |
| Endaural | A method that involves making a small incision above the earlobe. This is not used much anymore. |
Next comes the most important thing. That is closing the hole in the eardrum. For this , a graft is used, which is a piece of tissue. This tissue is usually taken from your own body.
- Where the tissue is taken: This tissue can be taken from a muscle membrane (connective tissue) near your ear or from a small piece of cartilage in front of your ear.
- Placing the tissue: The piece of tissue is then placed under the hole in the eardrum and closed neatly.
- Stabilization: To keep this new tissue from moving around, a small amount of foam is placed on top and bottom of it to hold it in place. Don't worry, this foam will dissolve over time.
Finally, if an incision was made, it is stitched up and a nice bandage is applied to finish the job. Sometimes the small bones behind the eardrum may be damaged. If that happens, the doctor will repair that too. Also, sometimes the hole in the eardrum can cause unwanted growths called cholesteatoma to form inside. If there is such a thing, it will also be removed, so the surgery may take a little longer.
What happens after the surgery? How long does it take to recover?
Although most people go home the same day, you may be asked to stay in the hospital for a day or so. The following are common in the first few days after surgery:
- A little blood-like fluid is coming out of the ear.
- A slight pain or feeling of heaviness in the ear.
- Hearing a 'chit chit' sound inside the ear.
- A slight loss of hearing (this may last for about six weeks).
There may be some pain for the first two or three days. You can use ordinary painkillers for that. But if the pain is unbearable, definitely talk to your doctor.
It may take about 10 days to two weeks for the discomfort to go away completely. However, it may take three months or more for full hearing to return . If your child has had surgery, and is not experiencing any discomfort, they can be sent to school in about three to five days. Ask your doctor for advice about this.
How should you be careful at home?
This is very important. Follow the doctor's instructions exactly. Here are some general things to remember.
| Things to do (Do's) | Things not to do (Don'ts) |
|---|---|
| Take your medication correctly: Use the antibiotic pills or ear drops prescribed by your doctor exactly as directed. | Don't pick your nose too hard: Don't pick your nose too hard for at least three weeks. If you have to sneeze, open your mouth. |
| Keep the ear dry: When bathing, place a cotton ball soaked in Vaseline® in the ear. You may also be advised not to wash your head for the first few days. | Do not lift weights: Do not lift weights over 5 kg until your doctor tells you to. Children should avoid PE for about two weeks. |
| Get plenty of rest: Get as much rest as possible. Don't run around too much and don't overwork yourself. | Avoid activities that put pressure on your ears: Avoid things like flying in airplanes and swimming for about a month. |
When you need to see a doctor urgently
You will see the doctor again two to three weeks after the surgery. He will check how your ear is healing. He will also schedule another hearing test in about two to three months.
However, if you experience any of these symptoms before then, call your doctor immediately:
- A change in the way the tongue feels or a tingling sensation in the face .
- Pus or fresh blood (dark red) coming out of the ear or cut.
- Ringing in the ears .
- Signs of infection include fever , redness, and warmth at the incision site.
- Ear pain or worsening hearing.
If you experience these symptoms, go to the nearest hospital Emergency Department (ETU) immediately:
* Rapid heartbeat
* Difficulty breathing
* Dizziness or loss of balance when walking
Ultimately, the results of this surgery are very successful. Nine out of 10 people have a successful eardrum repair. So, don't let a perforated eardrum stop you from living your life. Talk to your doctor and decide if this is the best option for you.
Take-Home Message
- Tympanoplasty is a surgical procedure to repair holes in the eardrum. This can restore hearing and prevent ear infections.
- This surgery is very successful, but it can take several months to fully heal.
- It is very important to follow the doctor's instructions exactly after surgery, especially keeping the ear dry, avoiding heavy lifting, and not picking your nose too hard.
- If you develop symptoms such as ear discharge, fever, severe pain, or dizziness, notify your doctor or hospital immediately.
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