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TYMPANOPLASTY

This term refers to a surgical procedure used to restore hearing using special techniques to graft the tympanic membrane (eardrum) and to reconstruct the middle ear so that sound vibrations can be transmitted to the inner ear.  The need for this type of surgery most commonly arises due to damage following infection, which has left portions of the middle ear bones missing and/or defects in the tympanic membrane (eardrum).  Blows to the head or sudden changes in air pressure may also produce the same problems in the middle ear.  Congenitally absent ossicles (middle ear bones) and/or tympanic membrane (eardrum) can be another reason for this surgery.

If the tympanic membrane needs to be repaired or replaced, a tissue graft is usually taken from a muscle above or behind the ear.  When portions of any of the bones or ossicles of the middle ear are missing, the continuity for conduction of sound from the tympanic membrane (ear drum) to the inner ear must be restored.  Transplantation of a specially structured ossicle(s) may be used to accomplish this.  These prosthetic devices are usually made of plastic materials, wire or cartilage.  “T.O.R.P.” refers to a Total Ossicular Replacement Prosthesis, while “P.O.R.P.” refers to a partial Ossicular Replacement Prosthesis.  Bodily rejection is rarely a problem with these prosthetic devices.  Hearing reconstruction (with TORP or PORP) may be performed either at the time of initial surgery or deferred for a second procedure 8-12 months later.

The risks of tympanoplasty are quite small, with the chances of any complication approximately 1%.  There may be loss of function in the inner ear that permanently impairs ones hearing.  The facial nerve may be uncovered by the disease process and in the course of surgery may begin to swell.  Facial weakness may follow, but fortunately this weakness is usually temporary.  The nerve of taste passes through the middle ear and may be bruised in the course of surgery; this may result in a temporary loss of distortion of taste.  On the whole, tympanoplasty carries little risk.  In most cases tympanoplasty is performed on an outpatient basis where patients may go home on the same day.   However, certain patients may need to stay overnight. 

In some patients it becomes necessary to perform a minor surgery called a “thiersch skin graft” in the 2-4 weeks after the tympanoplasty is performed.  See separate sheet for more details on this minor procedure.

 
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