Tympanoplasty

How to solve perforation, retraction and chronic otitis through ENT head and neck microsurgery (tympanoplasty)

 

Perforations of the eardrum

Tympanic perforation is a lesion (hole or tear) of the eardrum, the thin fibrous membrane separating the external auditory canal from the middle ear. Tympanic perforation is most often related to an ear infection such as otitis, but it can also be the result of an overpressure (violent slap, flying, scuba diving) or an accidental cause (cotton bud).

 

Diagnosis of the perforated eardrum

The tear in the eardrum causes acute and immediate pain when it is traumatic. Hearing loss, or tinnitus can also occur. In case of otitis or ear infection, a flow of pus is frequently noted.
Tympanic perforation is very easily detected by clinical examination of the ear by an ENT head and neck using an otoscope.

 

Surgical treatment of the perforated eardrum (tympanoplasty)

The tympanic membrane, if it is only slightly perforated and in the absence of chronic infection, will often heal on its own in 2 to 3 months until it returns to its original shape. Reconstruction of the eardrum by ENT head and neck microsurgery (tympanoplasty) is the only solution in cases that do not heal spontaneously. 

 

Tympanoplasty – reconstruction of the eardrum is performed in outpatient surgery (day hospital) under general anaesthesia and lasts from 30 minutes to 1 hour and a half, depending on the complexity of the operation. The technique consists of a reconstruction of the eardrum of the middle ear via a tissue graft taken from the patient himself during the operation. A resorbable dressing is slipped into the auditory canal at the end of the procedure.
The scar is variable depending on the type of procedure, either above or behind the ear.

 

When there is an associated chronic pathology of the middle ear, a chronic purulent discharge, a retraction pocket or a benign but dangerous tumour (cholesteatoma), the reconstruction of the eardrum may be associated with bone milling and / or placement of an ossicular prosthesis of the middle ear. Your ENT head and neck surgeon will explain the procedure to you. The surgical intervention can be long and requires hospitalization for three days.

 Post-surgery effects of a tympanoplasty

• Moderate, short-term pain

• Clean morning/evening scar with disinfectant solution

• Moisten the auditory canal using antibiotic drops

• Consultation after 8 days with your ENT surgeon, who will remove the dermal threads and provide local care

• Control and audiogram 1 month after surgery

 

As in any surgical intervention, there are risks of complications caused by the various anatomical elements in the ear and by the disease that motivated it, including a decrease in hearing, tinnitus, instability or vertigo, a disturbance in taste, or stenosis (narrowing) of the external duct of the ear.

It is forbidden to submerge the head under water during the cicatricial period and avoid any excessive or traumatic noise.

 

Coverage by social security

This surgery is covered by social security, but your head and neck ENT surgeon may request an additional fee according to his degree of experience.

 

Dr. Stéphane Hervé is an ENT specialist and head and neck surgeon who graduated from some of the best universities in France. He combines the precision of a refined ENT microsurgery technique with the technological innovation of the ZEISS OPMI VARIO 700 operating microscope.