Tympanoplasty (Eardrum Repair)

Tympanoplasty is a surgical procedure to repair a hole, tear or damage to the eardrum.
The eardrum is a thin membrane that separates the middle ear from the outer ear and plays a critical role in both hearing function and ear health.
Tears in the eardrum can lead to hearing loss, ear pain and recurrent middle ear infections.
Tympanoplasty aims to reconstruct the eardrum and middle ear to improve hearing function and reduce the risk of infection.

Causes of Eardrum Perforation

Perforation of the eardrum can occur for various reasons.
Among these reasons:

Middle Ear Infection (Otitis Media): Inflammation that accumulates in the middle ear can put pressure on the eardrum and cause it to rupture.
Trauma: The membrane can be damaged by a blow to the ear, the insertion of hard objects into the ear canal or during cleaning with an ear stick.
Sudden Pressure Changes: Sudden pressure changes such as air travel, diving or explosions can damage the eardrum.
Loud Noise Sudden and loud noises (explosions, high decibel music) can cause the eardrum to rupture.
Chronic Ear Inflammation: Long-term ear infections can weaken the structure of the membrane, leading to perforations.

Symptoms of a Perforated Eardrum

Symptoms of a ruptured or perforated eardrum include the following:

Hearing Loss: Damage to the eardrum causes sound waves transmitted to the middle ear to be blocked, resulting in hearing loss.
Ear Pain Pain may occur due to infection or pressure change in the ruptured membrane.
Ear Discharge There may be a discharge of yellow, white or bloody fluid from the ear.
This is usually a sign of an ear infection.
Tinnitus: A ruptured eardrum can cause sounds such as ringing or buzzing.
Dizziness Damage to the middle ear can lead to problems with balance, causing dizziness.

Suitable Candidates for Tympanoplasty

Tympanoplasty is suitable for people with a hole, tear or chronic infection of the eardrum.
Suitable candidates for this surgery:

People with a long-standing eardrum tear and hearing loss due to this.
Patients with damage to the eardrum due to recurrent ear infections.
People who experience tinnitus and dizziness due to damage to the eardrum.
Cases where the eardrum does not heal spontaneously and medication is not sufficient.

Preparation Before Tympanoplasty Surgery

Before tympanoplasty surgery, the patient’s ear structure, hearing and general health are evaluated.
Things to consider during the preparation phase:

Ear Examination: The ear canal and eardrum are examined in detail with an otoscope.
The middle ear is checked for fluid accumulation or infection.
Hearing Test Audiometry testing determines the degree and type of hearing loss.
Imaging: If necessary, computed tomography (CT) is used to evaluate the bone structures and mastoid cells of the middle ear.
Medication Use: Antibiotics or anti-inflammatory drugs may need to be used before surgery.
It is also recommended to stop taking blood thinners at least one week before surgery.

How is Tympanoplasty Surgery Performed?

Tympanoplasty surgery is usually performed under general anesthesia and takes approximately 1-2 hours.
During the operation, various techniques are applied depending on the structure of the patient’s eardrum and the size of the tear.
The basic stages of the procedure are as follows:

Access Inside the Ear: The surgery is performed through a small incision in the ear canal or behind the ear.
Repairing the Eardrum: A torn or perforated eardrum is repaired using the patient’s own tissue (usually cartilage or muscle membrane from behind the ear).
This tissue is placed on the eardrum to close the tear.
Correction of Middle Ear Structures: If necessary, the mobility and placement of the ossicles (hammer, anvil, stirrup bones) in the middle ear are checked.
Damaged ossicles are repaired or reconstructed.
Tampons and Dressing: Small tampons are placed in the ear canal to stabilize the eardrum.
The surgical site is also covered with a dressing.

Recovery after Tympanoplasty

The recovery period after tympanoplasty varies depending on the type of surgery and the general health of the patient.
Points to be aware of:

Removal of Tampons: The tampons placed in the ear after surgery are usually removed by the doctor within 1-2 weeks.
Ear Cleaning: It is important to keep the ear canal clean and dry during the recovery period.
Water contact should be avoided and the care instructions recommended by the doctor should be followed.
Hearing: In the first weeks, there may be a feeling of congestion in the ear.
It may take several months after surgery for hearing to return to normal.
Head Position: Keeping the head upright and avoiding sudden movements during the healing process helps the eardrum to heal faster.
Avoid Heavy Activities: Heavy exercise, weight lifting and movements that increase intra-aural pressure should be avoided for the first few weeks.

Advantages of Tympanoplasty Surgery

Tympanoplasty repairs damage to the eardrum, improving hearing function and reducing the risk of infection.
The advantages of the procedure are:

Restoring Hearing Function: Repairing the eardrum allows better transmission of sound waves to the middle ear and reduces hearing loss.
Reduced Risk of Infection: Since the tear in the eardrum is closed, the risk of recurrence of middle ear infections (otitis media) is reduced.
Elimination of Ear Discharge: The problem of discharge and inflammation from the ear is eliminated.
Use of Natural Tissue: Repair using the patient’s own tissue supports the natural healing process.

Risks and Side Effects

Tympanoplasty is generally a safe procedure, but it can have some risks and side effects:

Infection There is a risk of infection after surgery.
Postoperative care instructions should be followed to reduce this risk.
Hearing Loss: In rare cases, hearing loss may occur after surgery.
Dizziness After surgery, dizziness may occur due to problems with the inner ear.
Rerupture of the Eardrum: If the eardrum repair is unsuccessful, the tear may reoccur and additional surgery may be required.