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What is Tympanoplasty & Ossiculoplasty?
What is a tympanoplasty?
Tympanoplasty surgery is the term used for an operation where any part of the ear drum and space behind the ear drum is reconstructed or repaired. This operation is performed to either repair a hole in the ear drum or strengthen a part of the ear drum that is weakened and leading to risk to the bones of hearing. A hole or weakness in the ear drum may typically lead to recurrent ear infections and/or hearing loss.
What is an ossiculoplasty?
Sometimes a procedure called an Ossiculoplasty is required, either alone or in addition to tympanoplasty. This is undertaken when there is disease affecting any of the three bones of hearing (malleus/incus/stapes). During the operation these bones may be re-organised, re- built (sometimes using bone cement) or removed/replaced with a titanium prosthesis. These prostheses are safe for future MRI scans and will not typically trigger airport security machines.
What is involved with Tympanoplasty & Ossiculoplasty?
What will happen during surgery?
The operation is performed in an operating theatre. It can be done with sedation and local anaesthetic, although general anaesthetic can also be used. Often no external cuts are involved in the surgery and it can all be done through the natural ear canal. If access is narrow then sometimes a cut behind the ear or above the ear canal is required, which will be closed with absorbable sutures at the end. In this circumstance, a scar may be visible but usually heals very well. Surgery typically takes an hour or less, and you can go home on the same day, using routine pain relief medications.
What happens after surgery?
A pack is left in the operated ear for around 2 weeks to reduce the risk of post-operative infections. Depending on the type of packing chosen on the day we may ask you to place antibiotics drops on this for two weeks. Due to the ear packing you will usually have reduced hearing until this is removed in clinic. We will discuss with you precisely when the packing needs to be remove. A small trickle of blood or yellow liquid from your ear dressing is normal in the first few days. After surgery you must keep your operated ear dry for the first 6 weeks. The best way to avoid water getting into the operated ear canal is with a clean piece of cotton wool moulded with Vaseline that can be replaced daily. You must also avoid rapid air pressure changes and anything that ‘pops’ your ears for first 6 weeks. Flying and some overground train tunnels induce pressure changes and so are to be avoided (travelling on the London underground is fine). If you do need to fly sooner than 6 weeks after surgery (for example if you live abroad), please discuss this with us. You should avoid nose-blowing during this time, and sneeze through your mouth whenever possible. We will usually recommend that you take 1-2 weeks off from work and strenuous exercise. Occasionally your operation may involve placing a head bandage at the end of the operation – this can usually be taken off at home the next day.
Risks with Tympanoplasty & Ossiculoplasty
Tympanoplasty and Ossiculoplasty are safe procedures frequently performed without any problems. The nature of surgery and the anatomy involved means there are rare but documented risks of this kind of surgery which we will always talk through with you
Bleeding, Tinnitus, Infection, Dizziness, Pain, Numbness of ear, Ear dressing reaction, Graft failure, Failure or displacement of any prosthesis, Residual ear drum perforation, Scar, Facial weakness (very rare), Altered taste (1 in 5 temporary, permanent change very rare), No hearing improvement, Reduced hearing, Complete loss of hearing (very rare), The need for further surgery.
Alternatives to Tympanoplasty & Ossiculoplasty
The alternative to surgery for hearing loss and discharge may be to try a hearing aid first and keep the ear scrupulously dry. There is no risk associated with this treatment option and our in-house audiology team is available to discuss this further. Managing a hole in the ear drum without surgery may require more future appointments for observation. Some people find wearing hearing aids inconvenient and depending on the individual ear’s condition there may also be an increased frequency of infections.
To ask a question about Tympanoplasty / Myringoplasty at OneWelbeck or to book an appointment, contact our team today.
We are available from Monday to Friday: 8am – 8pm.