Tympanoplasty

Tympanoplasty surgery is technically the process of cleaning the inflammation in the middle ear and mastoid bone and repairing the eardrum and auditory system in the middle ear. Repair of the hole in the eardrum only (myringoplasty), repair of the ossicular system that provides sound transmission in the middle ear with membrane repair (tympanoplasty), removal of inflammation that has progressed into the mastoid bone (mastoidectomy) or a combination of these operations (tympanomastoidectomy) can be performed.

Should I have tympanoplasty surgery?

In case of established inflammation in the ear or permanent hole in the eardrum In this case, we recommend this surgery. If 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, if recurrent ear discharge is observed, it is a medical necessity to close the hole in the membrane in order to improve the quality of life and to prevent the progression of hearing loss and inflammatory complications. Evident hearing lossIf it is not possible to correct the problems in the ossicles that conduct sound in the same surgery, the sound conduction system should be repaired using various surgical techniques, cartilage, bone grafts or middle ear prostheses.

If an inflamed tissue called cholesteatoma is detected in the middle ear and mastoid bone, which progresses by dissolving the bone, this inflammation should be removed with surgery as soon as possible. In patients with cholesteatoma, the protection or repair of the hearing system is the second priority, and the main purpose is to clear the inflammation before it causes facial paralysis, inner ear-related hearing loss or intracranial complications (meningitis, brain abscess, etc.).

How is the surgery done?

During the surgery, very different surgical techniques can be applied to the middle ear and mastoid bone under the microscope. Tympanoplasty surgery It can be performed through incisions made through the ear canal, inside the ear or behind the ear. While surgery can be performed through the ear canal to repair only a small hole in the membrane, an incision is preferred through the ear in the holes in the middle and back of the membrane, in the holes in the front of the membrane and in cases where intervention to the mastoid bone is required. The choice of the surgeon who will perform the operation in this regard is the main deciding factor.

The tissue most commonly used to repair the eardrum is fascia or cartilage. Since this tissue is close to the surgical site, it can be easily obtained during surgery. We do not prefer artificial materials. When a repair is required to ensure the transmission of sound due to damage to the ossicles that conduct hearing, many different materials such as prostheses made of various materials, parts obtained from the cartilage in front of the ear canal, and the middle ear ossicles can be used by shaping them.

Postoperative

Patients can usually be discharged from the hospital by dressing on the first day after surgery. Afterwards, dressings are made at decreasing intervals. There is no standard approach for tympanoplasty operations that will suit every patient. The choice of surgical techniques and applications to be used during the operation, especially in cases with cholesteatoma, is mostly determined by the characteristics of the disease and the patient, the factors determined during the surgery and the experience of the surgeon.

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