Tympanoplasty,
also known as eardrum surgery, is a surgical procedure performed to repair or
reconstruct the eardrum.

Tympanoplasty
is carried out to repair the area of the eardrum that is completely or
partially perforated or torn. In this procedure, the damaged area of the
eardrum is cleaned and sutured or a tissue graft is used for repair. The goal
of the surgery is to reduce hearing loss and improve the ear health of the
patient.

This
procedure may be recommended for conditions such as chronic ear infections,
eardrum perforation, barotrauma (damage to the eardrum due to pressure
changes), or tears in the eardrum. However, the necessity of surgery and the
appropriate treatment method for each patient should be determined based on an
evaluation conducted by a specialist.

What is
the Eardrum?

The eardrum,
medically known as the tympanic membrane or myringa, is a thin membrane located
inside the ear canal of humans. It acts as a barrier separating the middle ear
from the external world. It has a conical shape and a diameter of approximately
8-10 mm. The eardrum is elastic and resistant to tension. It consists of two
different layers: the outer layer is an epithelial layer that opens to the
outside world and covers the inner part of the ear, while the inner layer is a
mucosal layer that faces the middle ear cavity and supports the eardrum. A
fibrous tissue ring located in the middle of the eardrum assists in its
stretching and vibration properties.

The eardrum
is an important part of the hearing process. Sound waves reach the eardrum from
the outer ear and cause it to vibrate. These vibrations are then transmitted to
the inner ear through three small bones in the middle ear (hammer, anvil,
stirrup). Proper functioning of the eardrum enables the effective execution of
the hearing process. It also helps with pressure equalization in the ear.
Pressure changes, such as during air travel or at high altitudes, can cause
pressure differences in the eardrum. In such cases, the eardrum can vibrate or
temporarily change its shape to balance the pressure difference.

What
Causes Eardrum Rupture?

The eardrum
in humans can be damaged due to various reasons. In some cases, surgery
performed by a specialized physician is necessary. The most common causes are
listed below:

•      
Middle
ear infections

•      
Hearing
devices

•      
Poor
ear hygiene

•      
Barotrauma

•      
Congenital
anomalies

What is
the Preparation Process Before Tympanoplasty?

Firstly, the
patient should consult an otolaryngologist (ear, nose, and throat specialist)
with their complaints. The doctor evaluates the condition of the patient's
eardrum, and learns their medical history and symptoms. Then, some examinations
and tests may be conducted to have a more detailed view of the area. These may
include an otoscopic examination, audiometry test (hearing test), and in some
cases, imaging tests (e.g., otologic tomography or MRI).

When eardrum
surgery is planned, blood tests are performed, the type of anesthesia is
determined, and other preparations before the operation are made. The patient
is instructed not to eat for a certain period before the procedure. The surgery
is mostly performed under general anesthesia. The person is also informed about
the operation day and post-operative follow-up appointments. It is important to
share any concerns or questions regarding the procedure with the doctor during
this process. Obtaining information about how the surgery will be performed,
expectations, the recovery process, and post-operative care is crucial.

How is
Tympanoplasty Performed?

At the
beginning of the operation, a small incision is usually made behind the outer
ear to access the ear canal. This allows the specialist to reach the damaged or
torn area of the eardrum. Different methods can be used to repair the damaged
eardrum. Small holes or tears can typically be closed with stitches. For larger
damages, repair surgery may be required. In this case, the damaged area is
cleaned, and a tissue graft is used to repair the eardrum.

In some
cases, additional procedures may be performed during the surgery. For example,
additional surgical interventions may be necessary to drain fluid accumulation
in the middle ear or repair damaged ossicles (small bones) in the middle ear.
At the end of the surgery, the incisions are usually closed with stitches or
surgical adhesive. This ensures that the scars behind the outer ear or in the
ear canal are nearly invisible.

It is
generally a quick and comfortable procedure. The duration of the surgery can
vary depending on the size of the damage, the treatment method, and the need
for additional interventions. After the operation, patients are usually kept
under observation and discharged within a few hours.

Postoperative
Care After Tympanoplasty

After the
ear surgery, the doctor may prescribe specific medications to reduce the risk
of pain or infection. It is important to take these medications regularly and
follow the given instructions. Dressings may need to be applied for a period to
protect and keep the surgical area clean. The patient receives detailed
information on how to perform this procedure.

After the
surgery, it is recommended to avoid heavy physical activities for a certain
period. Excessive exertion and strenuous movements can have a negative impact
on the recovery process. The patient should focus on resting and engaging in
calm activities for the recommended duration. Additionally, there should be no
contact with water in the application area for a while. Within the specified
time frame, showering, swimming pools, and the sea should be avoided.

In addition,
the specialist may perform a hearing test on the patient. The hearing level is
checked, and if necessary, suitable hearing aids or alternative treatments are
recommended. Prof. Dr. Selçuk İnanlı is a competent specialist in eardrum
surgery in Istanbul. Please contact us for more detailed information about the
procedure.