You have just been told you need tympanoplasty surgery and you are not even sure what it entails.

First you want to know what is involved. Well, the surgery is done to reconstruct the tympanic membrane (eardrum). You and your surgeon will decide if your surgery is done under local or general anesthesia. You may be one of those patients who prefer to be completely asleep.

During the surgery an incision is made into the ear canal and the remaining eardrum is elevated away from the bony ear canal and lifted forward.

The operating microscope helps to enlarge the view of the ear structures, giving a more detailed image to the ear surgeon. If the perforation is very large or the hole is far forward and away from the view of the surgeon, it may be necessary to perform an incision behind the ear. This elevates the entire outer ear forward, gaining access to the perforation. Once the hole is exposed fully, the perforated remnant is rotated forward, and the bones of hearing are inspected. There may be scar tissue and bands surrounding the bones of hearing. These can be removed either with micro hooks or laser.

The surgeon will identify the bones of hearing and press the ossicular chain to determine if the chain is mobile and functioning. Hopefully the chain is mobile and the rest of the surgery will concentrate on repairing the drum defect. Tissue will be taken from the back of the ear or from the cartilaginous lobe in front of the ear. This tissues are  thinned and dried. A gelatin sponge is then placed under the drum to allow for support of the graft. The surgeon will insert the sponge underneath the remaining drum remnant. The drum remnant is folded back onto the perforation to provide closure.

If opened from behind, the ear is then stitched together.  A sterile patch is placed on the outside of the ear canal and the patient returns to the recovery room. Generally, the patient can return home within two to three hours. Antibiotics are given along with a mild pain reliever such as Tylenol or Tylenol with Codeine.

After about ten days, the packing is removed and a good evaluation can then be obtained as to whether the graft was successful. Water is kept away from the ear and blowing of the nose is discouraged. If there are allergies or a cold, further antibiotics and decongestant should be given. Most individuals can return to work after five or six days unless they perform heavy physical labor, in which case the patient can return after two or three weeks.

After three weeks, all packing is completely removed under the operating microscope in the office. It can then be determined whether the graft has fully taken. In over 90 percent of cases, the tympanoplasty procedure is successful and a hearing test is performed at four to six weeks after the operation.

Keep in mind that is just a brief description of tympanoplasty surgery. For more information talk to your doctor or call a meeting with your surgeon at Outpatient Services East.

Phone:  205-838-3888   Web:  www.osesurg.com