The term tympanoplasty is a generic term that refers to any type of reconstructive procedure of the middle ear. Most tympanoplasties involve repair of the eardrum and/or repair of the middle ear hearing bones (hammer, anvil, stirrup). In some cases, a mastoidectomy procedure is combined with a tympanoplasty to eradicate a chronic infectious process such as a cholesteatoma.
Most tympanoplasties are outpatient procedures with optional overnight stay in our observation unit. The surgical times vary from about 20 minutes to 2 hours depending on the extent of the disease process and the technique for the repair. With hearing bones affected, a so called ossiculoplasty is performed with the intention to restore the continuity of the chain of hearing bones (ossicles).
Some tympanoplasties can be performed through the ear canal without an incision around the auricle. In some other cases, however, an incision behind the ear becomes necessary. An endaural approach, which utilizes an incision in the lateral aspect of the ear canal is rarely used.
The ear drum repair can be performed using a variety of tissues. Most commonly, temporalis fascia is used, which can be easily harvested through all approaches. This is a layer of fibrous tissue just over the chewing muscle. Thus, many patients experience some chewing issues after surgery. Other risks include unsuccessful ear drum repair with re-perforation or a lack of hearing improvement. Also, the facial nerve runs through the ear and is therefore at risk during every ear surgery. This risk, however, is very low and a monitoring system is routinely used.
Patients are usually asked to return for a clinic appointment about 1 week after surgery. Several other appointments will be required depending on the details of the procedure performed.