Doctors for Tympanoplasty

Tympanoplasty surgery is performed to repair perforated or ruptured eardrum by using a graft or prosthesis. A doctor recommends it when the eardrum hole does not heal on its own and other non-surgical treatments fail to treat the condition. The surgery usually takes 1-2 hours. A doctor first diagnoses the condition to understand the severity of the rupture and then suggests surgery accordingly. In some cases, tympanoplasty is performed together with other procedures, including ossiculolplasty, mastoidectomy, etc.

An ENT specialist recommends diagnostic tests before tympanoplasty surgery to understand the severity of the condition. These tests also help identify any underlying health condition that may complicate the surgery. Some of the standard diagnostic tests are as follows:

• Tuning fork test: It is a metal tool with two prongs that, when hit together, produce sound. It produces sound close to the ear, which the doctor uses to test the patient's hearing.
• Swab test: In this test, a doctor takes a swab sample from the ear discharge and sends it to a lab for culture in order to determine whether or not the middle ear is infected.
• Tympanometry: Tympanometry is a technique used to gauge how the eardrum reacts to changes in air pressure. To determine the severity of the eardrum perforation, the doctor measures the tympanum.
• Audiology: During this examination, the doctor plays sound at different levels and pitches to gauge the severity of the hearing loss.

Tympanoplasty is a simple eardrum repair surgery performed under the influence of general anesthesia. During the procedure, the surgeon makes an incision behind or in front of the ear. The approach also depends on the location and size of the hole in the eardrum. After that, the surgeon removes the edges of the hole and then closes it with a graft with the help of an endoscope. The graft helps in the growth of new cells that help in the closing of the hole in the eardrum. The surgeon secures the graft with the help of a spongy packing that dissolves on their own with time. The entire surgery takes 2-3 hours.

Types of tympanoplasty surgery can be classified on the basis of how a surgeon reaches the middle ear,

• Postauricular tympanoplasty: It is the most common type of tympanoplasty surgery. During this procedure, the surgeon reaches a tympanic membrane from behind the ear. After that, they make an incision behind the crease of the outer ear. It gives an excellent view of the entire eardrum as compared to other surgical approaches. A surgeon now placed a graft under the existing eardrum. A graft is then secure in place with a foam-like material that will dissolve after several weeks
• Tanscanal tympanoplasty: It is performed through the ear canal. This approach is limited to only a small perforation of the tympanic membrane, as it gives a limited or incomplete view of the front portion of the eardrum.

Here are some tips that you can follow to prepare yourself for tympanoplasty surgery:

• Detailed medical tests: Before surgery, it is important to undergo a detailed diagnosis to understand the severity and to ensure that you are healthy to undergo surgery.
• Quit smoking: It is advised to quit smoking as it can increase the risk of complications during or after surgery.
• Avoid certain medications: It is recommended to discontinue certain medications for a period of time before surgery as they can potentially increase the risk of bleeding.
• Avoid alcohol: It is extremely important to avoid alcohol before surgery as it makes the immune system weak and delays the recovery process after surgery.

The recovery time frame after tympanoplasty surgery differs from one person to another. Usually, recovery takes five to six weeks. Here are some tips that you can follow to promote the recovery process after surgery:

• Attend all the follow-up appointments: It is extremely important to attend all the follow-up appointments after surgery to monitor the recovery and look for any signs of complications.
• Take care of the surgical site: It is crucial to take care of the surgical site to avoid the chances of infection. Avoid applying chemical soaps around the surgical area.
• Follow all the diet instructions: After surgery, you must eat soft foods that are easier to chew and swallow, such as mashed potatoes, cooked vegetables, yogurt, soft cheese, scrambled eggs, etc.
• Avoid strenuous activities: You must avoid vigorous exercise after surgery, such as heavy lifting.
• Avoid swimming: You must avoid swimming for at least the first week after surgery to avoid any infection.

Mentioned below are some precautions that you must take for a swift and smooth recovery after a tympanoplasty surgery:

• Avoid certain physical activities: It is essential to avoid certain physical activities post-surgery, such as swimming, playing sports, etc. Moreover, you should also avoid going to places where there is loud music, shooting firecrackers, etc.
• Avoid traveling: It is best to avoid traveling for at least the first two to three weeks post-surgery. Flying in an airplane can build pressure and can pose a risk to the eardrum.
• Follow post-surgery instructions: It is important to follow post-surgery instructions recommended by your healthcare provider.

Here is a list of some essential questions that you must ask your surgeon before surgery to have a better understanding of the procedure and the risks and complications associated with it:

• Is tympanoplasty a major surgical procedure?
• What is the success rate of tympanoplasty surgery?
• What are the potential risks and complications of tympanoplasty surgery?
• What precautions do I need to take after tympanoplasty surgery to promote recovery?
• What are the risk factors for tympanoplasty surgery?
• What is the recovery period after tympanoplasty surgery?
• Is tympanoplasty a major surgical procedure?
• Is tympanoplasty painful?
• Does hearing improve after tympanoplasty surgery?
• What should I avoid after tympanoplasty surgery?
• What are the diet restrictions after tympanoplasty surgery?
• Is bleeding normal after tympanoplasty surgery?
• What are the different types of tympanoplasty surgery?
• What are the long-term side effects of tympanoplasty surgery?
• How can I prepare myself for tympanoplasty surgery?
• What should I avoid after tympanoplasty surgery?
• What is the best sleeping position after tympanoplasty surgery?

Tympanoplasty surgery is a safe and effective procedure. But, like any surgical procedure, it entails some risks and potential problems, such as

• Infection: Infection is a common side effect after a tympanoplasty surgery. The doctor usually recommends antibiotics to treat the infection. The eardrum may become inflamed and scarred if the infection is not properly treated.
• Chances of hearing loss: It is another possible risk of tympanoplasty surgery. Persistent hearing loss can be caused by scar tissue on the eardrum, changes in the inner ear, or damage to the facial nerve, which controls facial muscles and is involved in hearing.
• Damage to the nearby structures: There is a rare chance that the additional ear structures could sustain harm. Hearing impairments, vertigo, and balance concerns can result from damage to the ear's bone and cartilage.

The cost of tympanoplasty surgery in India typically ranges from INR 35,000 to INR 60,000. It is the estimated cost range of surgery and the final cost can vary depending on various factors like the cause of the ear injury, the middle ear tissues injured, etc. Some other factors that affect the cost of tympanoplasty surgery are:

• Treatment city
• Cost of hospitalization
• Post-surgical care
• Complications during or after the surgery
• Surgeon’e fees
• Cost of diagnostic test
• Insurance coverage, etc.
• Type of the surgery
• Patient’s age and health condition
• Choice of the surgical graft/implant