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Medical Disability Advisor  >  Tympanoplasty

Tympanoplasty


Related Terms


  • Eardrum Repair
  • Myringoplasty

Specialists


  • Otolaryngologist

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Factors Influencing Duration


The site and size of the perforation, status of the middle ear, the type of surgical approach used, surgical results, and the individual's reaction to the procedure affect length of disability. The state of the individual's health will affect the length of the recovery period.

Medical Codes


ICD-9-CM:
19.4 - Myringoplasty; Epitympanic, Type I; Myringoplasty by Cauterization, Graft; Tympanoplasty (Type I)
19.5 - Tympanoplasty, Other
19.52 - Type II Tympanoplasty; Closure of Perforation with Graft Against Incus or Malleus
19.53 - Type III Tympanoplasty; Graft Placed in Contact with Mobile and Intact Stapes
19.54 - Type IV Tympanoplasty; Mobile Footplate Left Exposed with Air Pocket Between Round Window and Graft
19.55 - Type V Tympanoplasty; Fenestra in Horizontal Semicircular Canal Covered by Graft
19.6 - Revision of Tympanoplasty

Definition


Tympanoplasty is a surgical procedure performed on the eardrum (tympanic membrane). There are three main indications for this procedure. These include a hole in the eardrum (perforation), calcium deposits, or a deformity known as a retraction pocket.

The most common reason for the surgery is repair of a perforation caused by infection, injury, or previous placement of tubes, (myringotomy). It may also be performed where the perforation in the eardrum did not completely heal via other means.

There are numerous causes for damages to the middle ear. Severe or chronic middle-ear infection is a major cause. Insertion of a sharp object in the ear such as a cotton swab to clean the ear or relieve an itch; an unseen twig on a tree, or hot slag from an industrial site may damage the eardrum. A sudden inward pressure in the ear, such as with a slap; a swimming or diving accident; a nearby explosion, or a sudden outward pressure or suction may also injure the middle ear.

Risks for damages to the middle ear and other problems of the eardrum increase with recent middle-ear infections or head injuries.

Source: Medical Disability Advisor



Reason for Procedure


Tympanoplasty is performed to correct a number of problems: a hole in the eardrum (perforation), calcium deposits, a damaged middle ear, or a deformity known as a retraction pocket. The most common reason for tympanoplasty is perforation caused by infection, injury, or previous placement of tubes.

Source: Medical Disability Advisor



How Procedure is Performed


The procedure is performed under general anesthesia and takes 2 to 3 hours. It may be done through the ear canal (transcanal approach) or via an incision behind the ear (postauricular approach).

In a transcanal approach, an instrument called an ear speculum is placed in the external ear canal, and an operating microscope is positioned. If necessary, the middle ear can be entered through an incision in the eardrum. Depending on the defect, a direct repair of a defect in the eardrum can be performed; or the defect may be repaired with a "patch" made of skin, fascia, or a vein graft.

Hearing is usually tested before and after surgery. Individuals usually leave the hospital the same day. Water in the ear must be avoided. A hair cap should be used when showering for a few weeks to keep the ear dry. No changes in activity or diet are needed following the procedure.

Source: Medical Disability Advisor



Prognosis


In most cases, tympanoplasty relieves pain symptoms completely. A slight amount of hearing loss may occur as a result of the procedure. Success depends on the size of the area to be repaired, and whether or not there are problems with other parts of the ear. If both eardrums are perforated, the success rate is lower. The procedure can have a less favorable outcome if the eardrum has become attached to the small bones of the middle ear.

Source: Medical Disability Advisor



Complications


The main complication specific to tympanoplasty is a disturbance in taste. This may happen if a certain nerve that runs right behind the eardrum is injured. As with any ear surgery, there are also the risks of dizziness and deafness. Additional risks include incomplete healing of the hole in the eardrum and damage to the small bones in the middle ear, causing hearing loss.

Source: Medical Disability Advisor



Return to Work (Restrictions / Accommodations)


Hearing may need to be evaluated if it is important to the individual's job. Loud noise and changes in atmospheric pressure may need to be avoided. Ear protection may be required.

Source: Medical Disability Advisor



General References


Cummings, Charles W., et al. "Tympanoplasty and Ossiculoplasty." Cummings: Otolaryngology: Head & Neck Surgery. 4th ed. Philadelphia: Mosby, Inc., 2005. 3058-3068.

Source: Medical Disability Advisor






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