What is Tympanoplasty

Tympanoplasty is a procedure to repair a hole in your eardrum (tympanic membrane) using a piece of tissue from another part of your body (skin graft). The tympanic membrane is a thin layer of tissue in your ear that can tear or become punctured. As a result, a hole can develop and can allow water and germs to enter your middle ear. This can cause infection and trouble hearing. The goal of tympanoplasty is to improve hearing and prevent future infections.

Tell a health care provider about:

• Recent colds or infections you have had.
• Recent drainage or moisture in your injured ear.
• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Foods tasting slightly salty or metallic for up to 6 months after surgery.
• Numbness or loss of feeling in part of the face (rare).
• Dizziness or a feeling that things are spinning around you (vertigo).
• Graft failure. This means that the graft does not attach to the tympanic membrane.
• Partial or total loss of hearing (rare).
• Noises in the ear, such as buzzing or echoing (tinnitus). This is rare.

What happens before the procedure?

• Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Your health care provider may examine your ear.
• You may have tests, including:
  • Hearing tests (audiometry).
  • X-rays.
• Follow instructions from your health care provider about eating or drinking restrictions.
• You may be given antibiotic medicine to help prevent infection.
• Plan to have someone take you home after the procedure.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic). Tympanoplasty is commonly performed with a general anesthetic.
• A skin graft will be removed from part of your body. Often, the graft will come from your scalp or your ear.
• An incision will be made in your ear canal or behind your ear.
• The surgeon will use a microscope to look at the hole in your tympanic membrane.
• The graft will be placed so that it covers the hole in your tympanic membrane.
• Dissolvable sponges will be placed in your ear to hold the graft in place.
• Antibiotic drops may be put in your ear to help prevent infection.
• The incision may be closed with stitches (sutures) or surgical glue.
• Your surgeon may cover the opening of your ear with bandages (dressings).

What happens after the procedure?

• You may feel dizzy or light-headed.
• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• Do not drive for 24 hours if you received a sedative.
• You may continue to receive fluids and medicine through an IV tube.
• You will have some ear pain. Medicines will be available to help you.

Care After Tympanoplasty

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild ear pain.
• A feeling of fullness in your ear.
• Popping or crackling in your ear.
• A small amount of blood or fluid draining from your ear for a few days.
• Difficulty hearing out of your ear for up to 6 weeks.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• If you were prescribed antibiotic ear drops, use them as told by your health care provider. Do not stop using the drops even if your condition improves.

Incision care and ear care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your ear, your incision area, and the area where your skin graft was removed (graft site) every day. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Driving

• Do not drive for 24 hours if you received a sedative.
• Do not drive or operate heavy machinery while taking prescription pain medicine.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 20 lb (9.1 kg) for 2 weeks.
• Do not fly in an airplane or put your head completely underwater until your health care provider approves.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves.
• If your health care provider approves showering, protect your ear using one of these methods:
  • Using a waterproof earplug.
  • Placing a piece of cotton in your outer ear and covering it with petroleum jelly.

General instructions

• Do not blow your nose or sneeze with your mouth closed for about 1–2 weeks after surgery. These actions may delay healing or move the piece of tissue (skin graft) covering the hole in your eardrum.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Follow instructions from your health care provider about eating or drinking restrictions. You may be instructed to avoid foods that are difficult to chew.
• Raise (elevate) your head above the level of your heart when you sleep for several days after your procedure. To do this, try putting two pillows under your head.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• You develop any of the following symptoms in your ear, your incision area, or your graft site:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Unusual warmth.
  • Pus or a bad smell.
• You vomit or feel nauseous.
• You have severe pain.
• You develop symptoms of a cold, such as sinus pressure or congestion.
• You get water inside your ear.
• Your sense of taste changes.

Get help right away if:

• You have severe ear pain.
• You suddenly get dizzy or have problems with balance.
• Your hearing suddenly gets worse.
• You lose feeling in any part of your face or neck.