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Tympanoplasty is an elective, ambulatory microsurgical procedure performed to close a perforation (hole) in the tympanic membrane (ear drum) when non-surgical methods are ineffective. Perforations may be caused by infections, injuries, flying with a cold and cotton swabs; symptoms include drainage or bloody discharge from the ear, hearing loss, dizziness when water enters the ear and frequent ear infections. Antibiotics, decongestants, ear drops and abrasion with a small hook are often tried before surgery is recommended.
Located behind the ear, the mastoid bone connects to the middle ear and, when healthy, is filled with air. Infection or disease in the ear or elsewhere can cause the mastoid to fill with fluid, mucus or excess tissue (such as a cholesteatoma, a benign tumor that may grow out of a healing perforated ear drum and cause hearing damage). When medications and other non-surgical treatments such as antibiotics or professional cleaning fail to resolve the problem, mastoidectomy may be performed. Complications from surgery are rare but may include drainage from the ear, infection, temporary dizziness or loss of taste on one side of the tongue, hearing loss and, rarely, nerve injury to the side of the face operated upon.
Ossicular reconstruction is the reconstruction of tiny bones of the middle ear. If the gap between the anvil bone and the stapes is small, a small piece of bone or cartilage from the patient can be inserted; if is is large, the incus bone is removed, modeled into a prosthesis, and reinserted between the stapes and the malleus. Reconstruction could also be achieved by inserting a strut made from artificial bone. For tympanoplasty with ossicular reconstruction, the patient usually stays in the hospital overnight. The recovery period is about four weeks.
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The surgical procedure for placing tubes in the ears has become one of the most commonly performed operations of any kind. A tiny tube, with a collar on both ends is slipped through a tiny incision in the eardrum. This pressure-equalization (PE) tube provides a temporary, extra Eustachian tube to allow bacteria and fluid to drain from the middle ear.
Patients with otosclerosis and significant hearing loss are candidates for a stapedectomy. During a stapedectomy, an incision is made in the skin of the ear canal, the skin and eardrum are lifted to expose the stapes bone, and the stapes bone is removed. An incision is made above the ear and the tissue is removed. The tissue is used to cover the opening created by the stapes bone removal. A prosthesis is put in place where the stapes bone had been and the eardrum and skin of the ear canal are laid back in place. The ear canal is then packed.
