Our Summary

This research paper compares two surgical techniques used to repair a perforated eardrum: endoscopic type I tympanoplasty and microscopic type I tympanoplasty. After reviewing and analyzing 16 studies involving 1179 procedures, the researchers found that both techniques had similar results when it came to the success of the graft (repair material), improvement in hearing after surgery, and operation time. However, the endoscopic procedure had better results in terms of cosmetic appearance and a lower incidence of canaloplasty, a procedure to widen the ear canal which can be necessary in some ear surgeries. In simple terms, both surgeries are equally effective at repairing a perforated eardrum and improving hearing, but the endoscopic method tends to leave a better cosmetic result and less often requires additional procedures to widen the ear canal.

FAQs

  1. What are the two types of surgical techniques used to repair a perforated eardrum discussed in this research paper?
  2. According to the research, how do the endoscopic and microscopic type I tympanoplasty techniques compare in terms of success, hearing improvement, and operation time?
  3. What advantages does the endoscopic procedure have over the microscopic type I tympanoplasty, according to the research findings?

Doctor’s Tip

A helpful tip a doctor might tell a patient about tympanoplasty is to follow all post-operative instructions carefully to ensure proper healing and optimal results. This may include keeping the ear dry, avoiding activities that could put pressure on the ear, and attending follow-up appointments as scheduled. It is also important to report any unusual symptoms or complications to the doctor promptly.

Suitable For

Patients who are typically recommended tympanoplasty are those with a perforated eardrum that has not healed on its own, leading to symptoms such as hearing loss, ear infections, and ear discharge. This can be caused by trauma to the ear, chronic ear infections, or a previous unsuccessful tympanoplasty. The decision to undergo tympanoplasty is made after a thorough evaluation by an otolaryngologist (ear, nose, and throat specialist) who will assess the size and location of the perforation, the patient’s overall health, and their hearing status.

In general, tympanoplasty is recommended for patients who have a relatively small perforation in the eardrum, good overall health, and realistic expectations for the outcome of the surgery. Patients with larger perforations, active infections, or underlying medical conditions that could complicate surgery may not be good candidates for tympanoplasty. Additionally, patients who have experienced hearing loss or other symptoms related to the perforated eardrum may benefit from tympanoplasty to improve their quality of life.

Overall, the decision to undergo tympanoplasty is individualized based on the specific needs and circumstances of each patient, and should be discussed thoroughly with a healthcare provider.

Timeline

Before Tympanoplasty:

  • Patient experiences symptoms such as ear pain, hearing loss, ear drainage, and recurring ear infections.
  • Patient undergoes a physical examination and hearing tests to determine the extent of the perforated eardrum.
  • Patient may undergo antibiotic treatment to prevent infection before surgery.

During Tympanoplasty:

  • Patient is put under general anesthesia.
  • Surgeon makes an incision behind the ear to access the perforated eardrum.
  • The perforation is repaired using a graft (often taken from the patient’s own tissue) to seal the hole.
  • Surgery typically takes 1-2 hours.

After Tympanoplasty:

  • Patient may experience mild discomfort, dizziness, and temporary hearing loss immediately after surgery.
  • Patient is discharged the same day or the next day and given instructions for post-operative care.
  • Patient may need to avoid getting water in the ear for a few weeks.
  • Follow-up appointments are scheduled to monitor healing and assess hearing improvement.

Overall, tympanoplasty is a relatively safe and effective procedure for repairing a perforated eardrum and improving hearing. Patients can expect to see improvements in their symptoms and quality of life following surgery.

What to Ask Your Doctor

  1. What is the success rate of tympanoplasty in general and specifically for my case?
  2. What are the potential risks and complications associated with tympanoplasty?
  3. How long is the recovery process and what can I expect during the recovery period?
  4. Will I need any additional procedures, such as canaloplasty, as part of the tympanoplasty surgery?
  5. What type of anesthesia will be used during the procedure and are there any potential side effects?
  6. How soon after the surgery can I expect to see an improvement in my hearing?
  7. Will I need to follow any specific post-operative care instructions or restrictions?
  8. What is the likelihood of the perforation reoccurring after the surgery?
  9. Are there any alternative treatment options to tympanoplasty that I should consider?
  10. How experienced are you in performing tympanoplasty surgeries and what is your success rate with this procedure?

Reference

Authors: Pap I, Tóth I, Gede N, Hegyi P, Szakács Z, Koukkoullis A, Révész P, Harmat K, Németh A, Lujber L, Gerlinger I, Bocskai T, Varga G, Szanyi I. Journal: Clin Otolaryngol. 2019 Nov;44(6):942-953. doi: 10.1111/coa.13407. Epub 2019 Oct 4. PMID: 31356724