Tympanoplasty (Repair of Perforated Ear Drum)
What is a tympanoplasty?A tympanoplasty is a surgical procedure that repairs or reconstructs the eardrum (tympanic membrane) to help restore normal hearing. This procedure may also involve repair or reconstruction of the small bones behind the tympanic membrane (ossiculoplasty) if needed. Both the eardrum and middle ear bones (ossicles) need to function well together for normal hearing to occur.
What are the indications for a tympanoplasty?This procedure is usually not performed (or needed) in children under four years of age. A tympanoplasty is recommended when the eardrum is torn (perforated), sunken in (atelectatic), or otherwise abnormal and associated with hearing loss. Abnormalities of the ear drum and middle ear bones can occur through injury, OTITIS MEDIA, congenital (at birth) deformities, or chronic ear conditions such as a CHOLESTEATOMA.
How successful is tympanoplasty in restoring normal hearing?Return to a normal range of hearing after tympanoplasty is dependent upon the extent of the abnormality. Surgeries that involve repair of the eardrum only usually have a success rate of 85-90%. A second operation may be necessary in some cases if the hearing is not restored to an acceptable level.
Are there any other options aside from tympanoplasty?Tympanoplasty in most cases is an elective procedure, meaning that it can be scheduled whenever the patient is ready to have it done. Another option instead of this procedure includes the use of a hearing aid. When the tympanic membrane has a hole (perforation) in it, earplugs are usually recommended to protect the middle ear from infection. In a few cases, such as a significant infection or a CHOLESTEATOMA, this procedure may prevent more significant damage to the ear and the surgery may need to be performed more urgently.
What is done in preparation for a tympanoplasty?Usually other ear, nose, and throat conditions are treated before a tympanoplasty is considered. For example, if an ADENOIDECTOMY is indicated, this surgery is usually completed before tympanoplasty.
OTITIS MEDIA of any type should not be present at the time of surgery, as infections in the ear makes the operation much more difficult and may ruin the reconstruction. If your surgeon has suggested certain medications prior to surgery, these should be done without exception to ensure a successful outcome.
A hearing test is performed to document any hearing deficiency. The more significant the hearing loss, the sooner the procedure should be performed. The eardrum will also be examined before surgery using a special operating microscope.
What is involved with a tympanoplasty?A tympanoplasty is performed with the patient fully asleep (under general anesthesia). A surgical cut (incision) is usually made behind the ear, the ear is moved forward, and the eardrum is then carefully exposed. The eardrum is then lifted up (tympanotomy) so that the inside of the ear (middle ear) can be examined. If there is a hole in the eardrum, it is cleaned (debrided) and the abnormal area can be cut away. A piece of fascia (tissue under the skin) from the temporalis muscle (behind the ear) is then cut and placed under the hole in the ear drum to create a new intact ear drum. This tissue is called a graft. The graft allows your child's normal eardrum skin to grow across the hole.
If needed, reconstruction of the middle ear bones (ossiculoplasty) or CHOLESTEATOMAremoval may also be performed at this time.
This surgery usually requires an overnight hospital stay. The child has a dressing (large bandage) over the surgical site. This is removed the next morning and the patient is discharged home. Occasionally, in older children, or those undergoing a less involved procedure, same-day surgery is possible.
Eardrops may be prescribed after discharge.
The most important part of this surgery for the parent is your part in restricting activity as outlined by your surgeon. By following these instructions very closely, you can make sure your child's result is the best it can be. Please refer to written post-operative instructions in your surgical packet or on this web site.
What are the risks and complications of a tympanoplasty?Because this surgery takes place in and around the ear, there are special risks for this surgery in addition to the usual risks of infection and bleeding. Because each child's situation is different, your surgeon will relate to you just how likely these complications are to occur.
HEARING LOSS - A tympanoplasty is performed to help restore normal hearing. However, some hearing loss (more common with ossiculoplasty) may still be present after the procedure. An operation is termed successful if the hearing is restored within 10-15 decibels of normal.
FACIAL NERVE INJURY AND PARALYSIS - Because the facial nerve runs close to the surgical site, injury although uncommon, can occur. This may result in temporary facial muscle weakness and/or loss of taste on one side of the tongue.
DIZZINESS - This complication after surgery is rare and is more likely to occur whenMASTOIDECTOMY is performed for CHOLESTEATOMA when the cholesteatoma has eroded the balance system.
LOSS OF GRAFT - Because this operation involves grafting using your child's own tissue, very rarely this tissue will not survive long enough for the hole in the eardrum to heal completely. In this case, another operation may be necessary. Because the success rate of this surgery is so high, re-operation also has a very high success rate.
Your surgeon will schedule follow up visits after surgery to look at the eardrum, to check hearing and to ensure normal healing. It is important to keep these appointments, as they will help to maximize the success of the procedure.
Tuesday, June 21, 2011
For those of you who have been enquiring, here is a run down of the surgery Quiddy will be having.
Monday, June 20, 2011
Saturday, June 18, 2011
Hoi An is famous for many things including their lanterns. At night the city lights up with a stunning display of colour and light. Traditionally made from bamboo and silk they come in a dazzling array of shapes and sizes.
|So hard to choose!|
|Decision made. Should I have guessed it would be pink?|
|She really can be quite feral when she puts her mind to it.|
|Scarlett got to steer the boat under the watchful eye of our Captain.|
|Local fishermen (and women)|
|Skilfully throwing out the nets. I have no idea how they do not get tangled in those things.|
|Hauling in the catch|
|It was great to watch!|
|A lot of work for not many fish but he seemed happy enough.|
|Even happier with some hard earned Dong in his hand and merrily on his way.|
|Me and my beautiful boy|
|Quiddy was most excited about the petrol station for boats|
|Our hotel, the Life Resort, from the river|
|The Market from the river|
|Thirsty work so ice cream spiders all round|
|View from out lunch spot, The Cargo Club.|
|I hope the wind does not change Quiddy|
|Cannot remember the last time I ate pav. It was sooooooo good!|
|What a dude!|
|No bamboo in this one due to the tea light candle. Probably a smart move.|
|Does this fur make me look fat? Seriously, the fattest little dog I have ever seen!|
|Nice photo bomb Nick! (and yes....it is not an hallucination, Natasha is in the pool!)|
|Quiddy was SO good about not getting his head wet. He is due to have an ear operation this month and we could not risk an infection. It was SO hot I'm sure all he wanted to do was dive in like his sister. Such a great kid!|
|Surfboards are so last year!|
|Bye for now Hoi An...and thanks. We had a blast!|