Tympanoplasty surgery is technically the process of cleaning the inflammation in the middle ear and mastoid bone and repairing the eardrum and hearing system in the middle ear. It can be performed only by repairing the hole in the eardrum (myringoplasty), repairing the ossicle system that provides sound transmission in the middle ear together with membrane repair (tympanoplasty), cleaning the inflammation that has progressed into the mastoid bone (mastoidectomy), or a combination of these surgeries (tympanomastoidectomy).
Should I have tympanoplasty surgery?
We recommend this surgery in case of inflammation in the ear or permanent hole in the eardrum. Although the ear with a hole in the membrane is protected from water and or there is no focus of infection in the nose and sinus area, in case of recurrent ear discharge, it is a medical necessity to close the hole in the membrane in order to both improve the quality of life and prevent the progression of hearing loss and inflammation-related complications. In patients with significant hearing loss, if it is not possible to correct the problems in the ossicles that transmit sound in the same surgery, the sound conduction system should be repaired using various surgical techniques, cartilage, bone grafts or middle ear prostheses.
Medium. If inflamed tissue called cholesteatoma is detected within the ear and mastoid bone and progresses by dissolving the bone, this inflammation must be removed with surgery as soon as possible. Protecting or repairing the auditory system is the second priority in patients with cholesteatoma, and the main goal is to clear the inflammation without allowing facial paralysis, hearing loss originating from the inner ear, or intracranial complications (meningitis, brain abscess, etc.) to occur.
How is the surgery performed? How is it performed?
During the surgery, many different surgical techniques can be applied to the middle ear and mastoid bone under the microscope.Tympanoplasty surgery is performed through the ear canal, inside the ear or behind the ear. It can be performed through incisions. While surgery can be performed through the ear canal to repair only a small hole in the membrane, the holes in the middle and back part of the membrane require intervention through the ear, and the holes in the front part of the membrane and the mastoid bone require intervention. In these cases, an incision behind the ear is preferred. In this regard, the choice of the surgeon who will perform the surgery is the main deciding factor.
The most commonly used tissue in the repair of the eardrum is fascia or cartilage. Since this tissue is close to the surgical field, it can be easily obtained during surgery. We do not prefer artificial materials. When a repair is needed to ensure the transmission of sound due to damage to the ossicles that transmit hearing, many different materials can be shaped and used, such as prostheses made of various materials, pieces obtained from the cartilage in front of the ear canal, and the middle ear ossicles themselves.
Post-surgery
Patients can usually be dressed and discharged from the hospital on the first day after surgery. Then, dressings are applied at decreasing intervals. There is no standard approach for tympanoplasty surgeries that will suit every patient. The selection of surgical techniques and applications to be used during surgery, especially in cases with cholesteatoma, is often determined by the characteristics of the disease and the patient, factors detected during surgery, and the surgeon's experience.
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