Our Summary

This paper is about a certain kind of ear surgery called tympanoplasty, specifically, type I underlay tympanoplasty. In this procedure, a graft made from a type of tissue called temporalis fascia is used. The researchers wanted to find out if it made a difference if the graft was dry or wet. They looked at all the studies they could find on the subject up to August 2016, screening 130 articles down to 7 that met their criteria.

The conclusion was that whether the graft was dry or wet didn’t seem to affect the success of the surgery. However, when a wet graft was used, the surgery tended to be quicker. They also found that worries about the number of a certain type of cell (fibroblasts) in the graft affecting the surgery’s success were not supported by the studies they looked at.

FAQs

  1. What is a type I underlay tympanoplasty?
  2. Does the state of the graft (wet or dry) affect the success of a tympanoplasty?
  3. Do the number of fibroblasts in the graft affect the success of tympanoplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about tympanoplasty is to follow post-operative care instructions carefully, including keeping the ear dry and avoiding activities that could put pressure on the ear, such as blowing your nose forcefully. It is also important to attend follow-up appointments to monitor healing and address any concerns.

Suitable For

Patients who are typically recommended tympanoplasty include those who have:

  1. Chronic ear infections or inflammation that have not responded to other treatments
  2. Perforations or holes in the eardrum that have not healed on their own
  3. Conductive hearing loss due to eardrum damage
  4. Recurrent ear infections that are causing hearing loss or other complications
  5. Patients with a history of trauma to the ear resulting in eardrum damage

Overall, tympanoplasty is recommended for patients who have persistent ear problems that are affecting their hearing or quality of life and have not improved with other treatments.

Timeline

Before tympanoplasty:

  1. Patient experiences symptoms such as hearing loss, ear pain, and recurrent ear infections.
  2. Patient undergoes a thorough evaluation by an ear, nose, and throat specialist to determine the need for surgery.
  3. Pre-operative tests such as hearing tests and imaging studies may be conducted to assess the extent of damage to the eardrum.

During tympanoplasty:

  1. Patient is placed under general anesthesia.
  2. Surgeon makes an incision behind the ear to access the middle ear.
  3. Damaged tissue in the eardrum is removed and the graft (dry or wet) is placed to repair the perforation.
  4. Surgery typically takes about 1-2 hours.

After tympanoplasty:

  1. Patient may experience mild pain and discomfort in the ear, which can be managed with pain medication.
  2. Patient is advised to avoid activities that may put pressure on the ear, such as swimming or flying, for a few weeks.
  3. Follow-up appointments are scheduled to monitor healing and assess hearing improvement.
  4. Full recovery can take several weeks, during which time patients are advised to avoid blowing their nose forcefully and to keep the ear dry to prevent infection.

What to Ask Your Doctor

Some questions a patient should ask their doctor about tympanoplasty include:

  1. What type of tympanoplasty procedure will be performed?
  2. Will a dry or wet graft be used in the surgery?
  3. What are the potential risks and complications associated with tympanoplasty?
  4. What is the success rate of tympanoplasty for my specific condition?
  5. How long is the recovery time after tympanoplasty?
  6. What post-operative care will be required after the surgery?
  7. Are there any lifestyle changes or restrictions I need to follow after tympanoplasty?
  8. How soon can I expect to see improvements in my hearing after the surgery?
  9. Are there any alternative treatment options for my condition?
  10. What is the long-term outlook for my ear health after undergoing tympanoplasty?

Reference

Authors: Jiang Z, Lou Z. Journal: J Laryngol Otol. 2017 Jun;131(6):472-475. doi: 10.1017/S0022215117000615. Epub 2017 Mar 20. PMID: 28318475