tympanoplasty

Surgery to repair a perforated tympanic membrane (hole in the eardrum), to improve hearing or to stop frequent ear infections that did not get better with other treatments.

For example, chronic suppurative otitis media can cause damage to the tympanic membrane, resulting in a non-healing perforation.
A middle ear infection may be caused by bacteria (e.g. Streptococcus pneumoniae, Haemophilus influenzae) and viruses like those that cause colds or flu.

The surgery uses graft to reconstruct the perforated tympanic membrane and restores the sound conduction apparatus of the middle ear.
Usually, it is made behind the ear.

(Types of grafts: Advantages / disadvantages)
• Autologous grafts (tissues from the same person): Readily available, biocompatible, and inexpensive.
• Alloplastic grafts (artificial alternatives): Reduced morbidity associated with harvesting the grafts (i.e. less pain, improved cosmetic outcome with no additional scarring). Risk of infectious disease transmission.

Examples of autologous grafts:
• temporal fascia
• tragal perichondrium, conchal perichondrium
• fascia lata
• ear canal skin
• periosteum

Examples of alloplastic grafts:
• acellular dermal matrix
• absorbable gelatin sponge

The patient may feel dizzy for a few days and have ear pain for about a week after surgery. Some bloody fluid may drain from the ear canal and the incision.
It may take a few months to heal the wound and improve hearing.

(Things to avoid while healing)
• Water in the ear (e.g. swimming)
• Strenuous exercises (e.g. heavy lifting)
• Activities that may put pressure on the eardrum (e.g. flying in an airplane, scuba diving, playing contact sports)

(Complications)
• Recurrence (including failure of the graft)
• Conductive hearing loss

Cf. cholesteatoma