What happens during tympanoplasty treatment?
Diagnosis
Tympanoplasty diagnosis is conducted through a physical examination and hearing tests. During the physical examination, the ENT doctor will collect your medical history to find out the nature and cause of the hearing loss. Once that is done, he will insert an otoscope in the ear canal to get a clearer view of the eardrum. After that, he will perform diagnostic tests such as:
- Tympanometry– Tympanometry is performed to measure the eardrum’s response to different air pressure. The doctor will note the measurement of the tympanum to detect the extent of the perforation in the eardrum.
- Audiology- During this test, the doctor will play sounds of various volumes and pitches to measure the severity of the hearing loss.
- Swab test- if there is any ear discharge, the doctor will collect a sample and take it for culture in a lab to identify if there is an infection in the middle ear.
- Tuning fork test- A tuning fork is a two-pronged metal instrument that is used to produce sound when struck together. The doctor will use it to produce sound next to the ear to evaluate the patient’s hearing ability.
Procedure
Once you have been diagnosed, your surgeon will help you prepare for your surgery. Ear surgery can be performed endoscopically or openly. Generally, endoscopic surgery is preferred because it leaves a small and barely noticeable scar in front of and behind the ear.
The surgery is performed outpatient under local anesthesia. In case only a tissue graft is required to repair the eardrum, it is extracted from the back of the ear due to its similarity to the eardrum and closeness to the surgical site. Once you are anesthetized, the surgeon will either cut behind your ear to reach the ear canal or work through your ear canal directly. After lifting your eardrum, he will fill the hole in the eardrum using a graft of your own cartilage, a connective tissue graft, or a synthetic material graft. Finally, he will close the incision with bio-absorbable incisions and place packing in the ear canal to keep the graft in its place. After the surgery, you will be moved to a recovery ward for post-surgical observation.
In case the middle ear bones are also damaged, a prosthetic implant will be placed in the place of the damaged bones during the same procedure.
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