Our Summary
This research paper is about a study carried out on military personnel who had surgery (tympanoplasty) to repair a ruptured eardrum (tympanic membrane perforation) caused by blasts. The study was done on 254 soldiers who had the surgery between April 2005 and July 2014.
The study found that the surgery was successful in about 82.1% of the first attempts made. The success rate of the surgery was not linked to the size and type of the ruptured eardrum or the time taken between the injury and the surgery.
In some cases (9.1%), an additional surgery (ossiculoplasty) was needed to repair the small bones in the ear. In others (4.3%), a type of skin cyst, called a cholesteatoma, developed after the surgery. The risk of this cyst developing increased with the size of the eardrum rupture and ruptures at the edge of the eardrum.
The study concludes that the success rates of surgery for eardrum ruptures caused by blasts are lower than for other types of eardrum injuries. The researchers also recommend close monitoring of patients after surgery due to the risk of the skin cyst developing.
FAQs
- What is the success rate of the first attempt at tympanoplasty based on the study?
- What additional surgeries might be needed after a tympanoplasty?
- What factors increase the risk of a cholesteatoma developing after tympanoplasty surgery?
Doctor’s Tip
A helpful tip a doctor might give 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 eardrum. It is also important to attend follow-up appointments to monitor for any potential complications, such as the development of a cholesteatoma. If any changes in hearing or symptoms occur, it is important to contact your doctor right away.
Suitable For
Patients who are typically recommended for tympanoplasty include those with:
- Ruptured eardrums (tympanic membrane perforation) caused by blasts or explosions, as seen in military personnel in the study.
- Chronic ear infections that have resulted in eardrum perforation.
- Conductive hearing loss due to eardrum perforation.
- Patients with persistent ear pain, drainage, or hearing loss despite conservative treatment.
- Patients with abnormal growths in the middle ear, such as cholesteatomas, that require surgical removal.
- Patients with a history of repeated ear infections or trauma to the ear.
- Patients with a history of unsuccessful previous eardrum repair surgeries.
It is important for patients to undergo a thorough evaluation by an otolaryngologist (ear, nose, and throat specialist) to determine if they are suitable candidates for tympanoplasty. The decision to undergo surgery should be based on the individual patient’s symptoms, medical history, and overall health.
Timeline
The timeline of what a patient experiences before and after tympanoplasty would typically involve the following:
Before surgery:
- Patient experiences symptoms such as hearing loss, ear pain, discharge from the ear, and/or ringing in the ear
- Patient consults with an ear, nose, and throat (ENT) specialist who recommends tympanoplasty to repair the ruptured eardrum
- Pre-operative assessments and tests are conducted to evaluate the extent of the damage and determine the best course of action
- Patient undergoes pre-operative preparation and counseling about the procedure, potential risks, and expected outcomes
After surgery:
- Patient undergoes tympanoplasty to repair the ruptured eardrum, which may involve using a tissue graft to patch the hole in the eardrum
- Patient is monitored closely in the immediate post-operative period for any complications such as infection, bleeding, or anesthesia-related issues
- Patient may experience temporary hearing loss, pain, and discomfort in the ear following surgery
- Patient is advised to follow post-operative care instructions, which may include keeping the ear dry, avoiding loud noises, and taking prescribed medications
- Follow-up appointments are scheduled to monitor the healing process and assess the success of the surgery
- Patient may require additional surgeries or treatments if complications arise, such as ossiculoplasty for damage to the small bones in the ear or treatment for a cholesteatoma
Overall, the timeline of a patient’s experience before and after tympanoplasty involves a combination of pre-operative preparation, surgery, post-operative care, and follow-up monitoring to ensure the best possible outcome for repairing a ruptured eardrum.
What to Ask Your Doctor
- What is tympanoplasty and how does it work to repair a ruptured eardrum?
- What are the success rates of tympanoplasty for repairing eardrum ruptures caused by blasts, as compared to other types of eardrum injuries?
- Are there any specific factors that can affect the success of tympanoplasty for repairing eardrum ruptures caused by blasts?
- What is the likelihood of needing additional surgeries, such as ossiculoplasty, after undergoing tympanoplasty for a ruptured eardrum caused by blasts?
- What are the risks associated with developing a skin cyst (cholesteatoma) after undergoing tympanoplasty for a ruptured eardrum caused by blasts?
- How will I be monitored after the surgery to ensure that any potential complications, such as a skin cyst, are detected and treated promptly?
- Are there any specific precautions or lifestyle changes I should make following tympanoplasty to ensure the best possible outcome?
- What is the expected recovery time and post-operative care for tympanoplasty for a ruptured eardrum caused by blasts?
- Are there any alternative treatment options or therapies that may be considered for repairing a ruptured eardrum caused by blasts, if tympanoplasty is not successful?
- How often will I need to follow up with my doctor after undergoing tympanoplasty for a ruptured eardrum caused by blasts?
Reference
Authors: Keller M, Sload R, Wilson J, Greene H, Han P, Wise S. Journal: Otolaryngol Head Neck Surg. 2017 Dec;157(6):1025-1033. doi: 10.1177/0194599817717486. Epub 2017 Jul 4. PMID: 28675101