Tympanoplasty in India - Causes, Symptoms and Treatment

Tympanoplasty is the name of a surgery which repairs the hole in the eardrum, known as the perforated eardrum. The procedure is done in the hospital by giving general anesthesia. The surgery takes two or more hours. Tympanoplasty is generally a procedure for children. However, in some cases, adults may also need the procedure.

What is an Eardrum?

When any sound wave reaches the eardrum it causes vibration. The vibrations are then carried to the tiny bones of the middle ear. Then these bones transfer the signals to the inner ear. The eardrum consists of a thin connective tissue membrane which has skin on the outside and mucosa on the inside.

The eardrum is a complex part of the process of the hearing process system. It protects our middle ear from bacteria causing infection. But sometimes an infection may lead to perforation in the eardrum.

The eardrum may face problems like perforation and inflammation which is known as tympanitis.

What is Tympanitis?

An inflammation of the tympanic membrane, or eardrum, is medically referred to as tympanitis. The eardrum may become inflamed due to trauma or bacteria. It can leave a serious impact on hearing.

Causes of Tympanitis

There are various factors involved in the inflammation of the eardrum.

  • Middle ear infection or glue ear mainly occurs in children
  • Injury to head or ear
  • Poking to the ear
  • Eustachian tube dysfunction
  • Bacterial infections like bullous myringitis
  • Swimmer’s ear, a type of fungal or bacterial infection

Symptoms of Tympanitis

The symptoms of tympanitis are:

  • Redness and swelling in the ear
  • Itchiness in the ear
  • Pain in one or both the ears
  • Leakage of excess fluids
  • Temporary loss of hearing
  • Difficulty in sleeping

Treatment of Tympanitis

The treatment of tympanitis depends on the cause of it.

1. Middle ear infection -

In the middle ear infection, the doctor may prescribe you some pain killers to relieve the pain. In some cases, the doctors may also prescribe antibiotics. But it can get cured even with antibiotics some days after the diagnosis using an otoscope.

2. Bullous myringitis -

In this type of infection the doctors usually prescribe antibiotics and pain killers.

3. Swimmer’s ear -

The doctors may prescribe antibiotic eardrops which contain steroids that reduce inflammation.

What is a Perforated Eardrum?

A perforated eardrum is a hole in the thin tissue which separates the ear canal from the middle ear that iseardrum. Eardrum perforationmay result in loss of hearing. It can also make the middle ear weak causing other infections. A perforated eardrum gets healed within a few weeks without any treatment. However, sometimes a patch or surgery is required to repair the hole. Everything is discussed here about theperforated eardrum and its treatment.

Symptoms of a Perforated Eardrum

You will observe these signs if you have a perforated eardrum or other ear infection.

  • Earache or pain in the ear
  • A sudden loss of hearing- difficulty in hearing or you can hear a muffled sound only
  • Itchiness in your ear
  • Leaking of fluid, mucus-like or blood, from your ear
  • Fever-high temperature
  • Buzzing or ringing in your ear
  • Spinning sensation
  • Nausea or vomiting

Causes of a Perforated Eardrum

A hole in the middle ear or a perforated eardrum may be caused by:

1. Otitis media -

Otitis media means a middle ear infection often caused by the gathering of fluids in your middle ear. The pressure created by these fluids may result in a perforated eardrum.

2. Barotrauma -

Barotrauma is the stress applied on the eardrum when the pressure of air in the middle ear and the pressure of the air surrounding you are unsteady. Barotraumas are often caused when the pressure of air changes in connection with air travel.

3. Acoustic trauma -

Acoustic trauma means a sudden loud sound or blast, such as a gunshot or explosion, overpowering the sound wave coming to the ear and can sometimes cause a perforated eardrum.

4. Objects in your ear -

If you put small objects, such as a hairpin or cotton bud, can tear the eardrum.

5. Head trauma -

Injury to the head, like a fracture on the skull, may result in the damage or dislocation of the eardrum.

What Happens when the Eardrum gets Perforated?

Generally, the perforated eardrum gets healed within three to six months on its own. But if it fails to do it some severe problems may occur.

1. Loss of hearing -

Most of the time hearing loss is temporary. It only lasts until the tear in the eardrum has healed. The area and the size of the hole can decide the effect of loss of hearing.

2. Infection in the middle ear -

The hole in the eardrum can lead to making the area vulnerable resulting in an attack of bacteria in the ear. It can create chronic infection along with a perforated eardrum.

3. Cholesteatoma -

This happens very rarely though, when this cyst gets developed in the middle ear, composing of skin cells, can result in long-term damage to the eardrum. A cyst can create a friendly environment for the bacteria which can damage middle ear bones.

What are the things you can do if you have a perforated eardrum?

Generally, perforated eardrums don’t need to be treated as it can get healed by itself.

Try to follow these tips during the healing process so that the chances become less for ear infection:

  • Try to avoid putting anything in your ear like eardrops or cotton buds until and unless your doctor advice it
  • Take extreme care to avoid putting water in your ear
  • Don’t blow your nose too hard as it can lead to damage more in the eardrum
  • Try taking pain killers to relieve the pain
  • Protect your ears from unnecessary noise by wearing protective earplugs

What is eardrum perforation treatment?

When your perforated eardrum doesn’t get healed on its own then you must get eardrum perforation treatment. In tympanoplasty, the doctor will heal the eardrum by applying patches on the hole. It is also done through the ear canal or an incision at the back of your ear. A tissue graft is taken from behind your ear which is used as the patch. Other than the tissue the doctors may also use synthetic material grafts.

Some Contraindications in Surgery

The doctor will inform you about the risks and benefits involved in the surgery before recommending tympanoplasty. If anesthesia doesn’t suit you, it will be avoided by the doctor.

Anesthesia can be risky for patients:

  • Addicted to alcohol
  • Allergies to anesthesia
  • Having asthma
  • Having diabetes
  • Kidney problems
  • Obesity
  • Neurological condition
  • Sleep apnea
  • Having heart disease
  • High blood pressure

Risks Involved with Surgery

Risks are involved with any kind of surgery. But as tympanoplasty is done in a small area, the risks are less.

Some risks involved are:

  • Failure of the graft
  • Ringing in the ear
  • Change of taste
  • Dizziness

What happens during the surgery?

The procedure of the surgery is done in the hospital.

The doctor will make a small cut in front or behind your ear to take a small tissue from your skin. They will then, with the help of small surgical instruments, patch the hole of your eardrum with that piece of tissue. After that, a dressing will be placed to hold the patch. It will help to resist water and germs from going in. The patch has to stay in place for 2 to 3 weeks. The whole process of surgery usually takes two hours.

After spending one night for observation in the hospital if there are no further complications you will get discharged. Children are usually discharged on the same day if their vital signs are stable.

What happens after the surgery?

Follow the complete guidelines provided by the doctor for the recovery process. You must avoid heavy lifting or strain for at least 2 weeks. The doctor may also call you within a week to make sure everything is fine and to remove the stitches.

You may face some issues like drainage of fluids. You can use cotton balls to keep the area dry. The doctor can also prescribe you some ear drops to use after surgery.

Activities to Avoid After Surgery

Try to avoid these activities without asking permission from the doctor.

  • Smoking
  • Swimming
  • Avoid contact with sick people
  • Sports
  • Avoid blowing your nose too hard

Tympanoplasty may take two to three months to recover fully. It is advised to follow the instructions of the doctor to ensure a safe recovery. You must have patience while dealing with the recovery phase.

Tympanoplasty FAQs

Is a perforated eardrum dangerous?

A perforated eardrum is not dangerous and usually heals on its own in some weeks. But it is better to consult a general physician because if it doesn’t get healed it may cause loss of hearing.

How do I know if my eardrum is perforated?

You will realize that your eardrum is perforated by the sudden loss of hearing or just a muffled sound. You may also feel a sharp pain in the ear. There are other symptoms too which help you in knowing that your eardrum is perforated like- itchiness in the ear, vomiting or high temperature.

When does hearing improve after tympanoplasty?

No surgery in the world can guarantee a 100 per cent success rate. But according to a study 90-95% is the success rate of tympanoplasty. The improvement in hearing depends upon the condition of the ossicles.

What is water treatment behind the eardrum for adults?

Healthcare practitioners frequently perform water treatment behind the eardrum for adults to address a variety of ailments, such as ear infections and blockages. To eliminate any debris or trapped fluids, the middle ear is immediately irrigated with a sterile saline solution as part of the therapy. Using specialized equipment made for safe insertion into the ear canal, the treatment is normally carried out while the patient is under local anesthesia. Healthcare professionals are trained to carry out this process safely and successfully while minimizing any dangers to the patient's hearing or general health.

How do I know if my eardrums are perforated?

Are you thinking, “How do I know if my eardrums are perforated?” There are many factors, including exposure to loud noises, abrupt changes in air pressure, or injury that can result in a perforated eardrum. Sudden hearing loss, ear pain or discomfort, ringing in the ears or tinnitus, and a fluid flow from the ear are some of the signs of a burst eardrum. Vertigo or dizziness may occur in extreme situations. It is critical to get medical help right away if you think your eardrums may have been punctured. An otoscope will be used during an examination by an ENT expert to look for any obvious evidence of perforation in the inner ear.

What is eardrum grafting?

Tympanoplasty, also the name for eardrum grafting, is a surgical operation used to reconstruct or restore the eardrum. In order to build a new eardrum, the technique often entails making a tiny incision behind the ear and removing tissue from another area of the body, including the temporalis fascia or cartilage. Eardrum grafting is frequently done to treat eardrum perforations or rips brought on by injury, infection, or persistent middle ear disorders. When the middle ear region has been damaged, surgery can also be performed to enhance hearing.