Our Summary

This research paper discusses a surgical procedure used to repair a specific area of the ear. The process involves converting one type of surgery, the canal wall down tympanoplasty, into another, the canal wall up tympanoplasty. This is achieved by filling certain parts of the ear (the mastoid and epitympanic cavities) with a synthetic material known as bioactive glass, and then re-shaping the external ear canal to its normal size. This procedure has been found to significantly improve patients’ quality of life without increasing the risk of a recurrence of cholesteatoma, a type of skin cyst that can occur in the middle ear and mastoid bone. However, the success of the surgery is heavily reliant on the skill and precision of the surgeon.

FAQs

  1. What is the surgical technique described to transform canal wall down tympanoplasty into canal wall up tympanoplasty?
  2. How does the use of synthetic tissue (bioactive glass) in tympanoplasty improve health-related quality of life?
  3. Is there an increased risk of recurrent or residual cholesteatoma after the described tympanoplasty procedure?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tympanoplasty is to follow post-operative care instructions carefully to ensure proper healing and reduce the risk of complications. This may include keeping the ear dry, avoiding activities that could put pressure on the ear, and attending follow-up appointments for monitoring progress. It is also important to communicate any concerning symptoms or changes to the doctor promptly.

Suitable For

Tympanoplasty is typically recommended for patients who have a perforated eardrum, chronic ear infections, hearing loss, or other issues with the middle ear. Patients with recurrent or residual cholesteatoma may also benefit from tympanoplasty surgery. In some cases, patients who have undergone canal wall down tympanoplasty may be recommended for canal wall up tympanoplasty to improve their quality of life and reduce the risk of complications.

Timeline

Before Tympanoplasty:

  1. Patient experiences symptoms such as hearing loss, ear pain, and recurrent ear infections.
  2. Patient undergoes a thorough medical history and physical examination by an otolaryngologist.
  3. Diagnostic tests such as audiometry and tympanometry are conducted to assess the extent of hearing loss and middle ear function.
  4. Imaging studies such as CT scans may be performed to evaluate the anatomy of the middle ear and mastoid cavity.
  5. Surgical consultation is scheduled to discuss the possibility of tympanoplasty as a treatment option.

After Tympanoplasty:

  1. Patient undergoes preoperative preparation which may include blood tests, medication adjustments, and instructions on fasting before surgery.
  2. Tympanoplasty surgery is performed under general anesthesia, where the surgeon repairs the perforated eardrum and reconstructs the middle ear ossicles.
  3. Postoperative care includes pain management, antibiotics to prevent infection, and instructions on ear care and activity restrictions.
  4. Follow-up appointments are scheduled to monitor healing progress, remove sutures, and assess hearing improvement.
  5. Patient gradually resumes normal activities and experiences improved hearing and relief from previous symptoms such as ear pain and recurrent infections.

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 after tympanoplasty, and what can I expect during this time?
  4. Will I experience any hearing loss or changes in my hearing after the surgery?
  5. Will I need any additional procedures or follow-up appointments after the tympanoplasty?
  6. How soon can I return to my normal activities, such as work or exercise, after the surgery?
  7. Are there any lifestyle changes or precautions I should take after the surgery to ensure successful healing?
  8. What type of anesthesia will be used during the surgery, and are there any potential side effects or risks associated with it?
  9. Can you explain the specific technique that will be used for my tympanoplasty surgery?
  10. Are there any alternative treatment options to consider, and how do they compare to tympanoplasty in terms of effectiveness and recovery time?

Reference

Authors: Fieux M, Tournegros R, Zaouche S, Tringali S. Journal: Eur Ann Otorhinolaryngol Head Neck Dis. 2022 Oct;139(5):293-296. doi: 10.1016/j.anorl.2021.09.001. Epub 2021 Sep 14. PMID: 34535425