From the Guidelines
Tympanoplasty is a surgical procedure to repair the tympanic membrane, which is the eardrum, and may also involve repairing or replacing the middle ear bones.
Key Points
- The goal of tympanoplasty is to restore hearing and prevent further ear infections [ 1 ].
- The procedure can be performed using different types of graft materials, such as temporalis muscle fascia or cartilage, with cartilage grafts showing fewer postoperative tympanic membrane perforations [ 1 ].
- Tympanoplasty is typically recommended for patients with a perforated eardrum, chronic ear infections, or hearing loss due to middle ear damage.
- The success rate of tympanoplasty is high, with most patients experiencing significant improvement in hearing and reduction in ear infections.
- As with any surgery, there are potential risks and complications, such as infection, bleeding, or further hearing loss, which should be discussed with an ear, nose, and throat (ENT) specialist before undergoing the procedure. Some key considerations for post-operative care include:
- Using antibiotics to prevent infection
- Managing pain with medications such as acetaminophen
- Avoiding heavy lifting, bending, or strenuous activities for several weeks after surgery
- Keeping the ear dry to prevent infection
- Following up with an ENT specialist to monitor healing and remove any packing or sutures.
From the Research
Definition and Purpose of Tympanoplasty
- Tympanoplasty is a surgical procedure used to eradicate chronic middle ear infection and reconstruct hearing in infected ears 2, 3, 4, 5, 6
- The primary goal of tympanoplasty is to repair the tympanic membrane and restore the conductive hearing mechanism (eardrum and ossicles) 3
Surgical Techniques and Grafting Materials
- Various cartilage grafting techniques have been described, including the palisade, cartilage island, and cartilage shield 2
- Cartilage is often used as a grafting material due to its increased stability and resistance to negative middle ear pressure, especially in cases at high risk for failure 2, 6
- Temporal fascia graft is also used in type 1 tympanoplasty, with comparable anatomical and audiological results to cartilage graft 6
Outcomes and Success Rates
- Graft take rates have been reported to be high, with 97.29% success rate in one study 2
- Hearing improvement has been significant, with mean postoperative pure-tone average air-bone gap improvement ranging from 20.2 dB to 24.79 dB at different frequencies 2
- Tympanoplasty has also been shown to improve tinnitus in patients with conductive hearing loss, with 82.6% of patients experiencing improvement or elimination of tinnitus after surgery 3