TYMPANOPLASTY

General Information

DEFINITION-Repair, removal or bypass of an obstruction or defect in the middle ear that prevents sound waves from reaching the inner ear. This is called conductive hearing loss, which can be total or partial. Usually, it is caused by chronic infection in the middle ear.

BODY PARTS INVOLVED-Eardrum (tympanic membrane); middle ear cavity; skin separating middle ear from inner ear; inner ear.

REASONS FOR SURGERY-Restoration of, or improvement in, hearing ability.

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES-Ear, nose and throat specialist (otolaryngologist).

WHERE PERFORMED-Hospital

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; hearing tests.
• After surgery: Blood studies; hearing tests.

ANESTHESIA-General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An instrument called an ear speculum is placed in the external ear canal, and the operating microscope is positioned.
• The middle ear is entered through an incision in the eardrum.
• Depending on the defect, one of the following methods is used: Repair of a defect in the eardrum. Closure of a defect in the eardrum with a skin graft. Fenestration, the creation of a new opening into a part of the inner ear. This method is used to treat otosclerosis (see Illness section).

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.

AVERAGE HOSPITAL STAY-3 to 5 days.

PROBABLE OUTCOME-Expect complete healing without complications. Hearing should improve noticeably. Allow about 4 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• Keep the ear dry.
• Use warm compresses or heat lamps to relieve discomfort beginning 24 hours after surgery.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 4 weeks after surgery. > Resume driving about 2 weeks after returning home.

DIET--Liquid diet the first day after surgery, then no special diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.