Our Summary

This study looked at the healing process after a type of ear surgery called tympanoplasty, which is usually done to fix a hole in the eardrum (tympanic membrane perforation or TMP). Healing can sometimes be less than perfect after this operation, with issues like scarring. The researchers wanted to see how often this happens when patients use a certain type of ear drop (otic quinolones) after surgery.

They looked at the medical records of 100 patients who had this surgery at a high-level medical center. They checked these records for any issues with healing and changes in hearing 1 to 2 years after the operation.

The results showed that while most patients (93.2%) had their eardrum hole close up, over a third (34.2%) had some sort of healing issue. Some had more serious problems (20.6%), like the hole opening up again, tissue overgrowth, scarring, or other complications. Others (13.7%) had ongoing issues like ear discharge or infections. The researchers didn’t find that any medical, surgical, or patient factors affected these outcomes.

The average difference between air and bone conduction hearing didn’t change between patients with and without healing issues. This means that the hearing results were the same, no matter if the healing was perfect or not.

In conclusion, less than perfect healing is common after this type of ear surgery. The researchers suggest that there may be ways to improve healing after this operation, beyond just making sure the eardrum hole closes up.

FAQs

  1. What is the frequency of suboptimal healing after tympanoplasty with the use of otic quinolones postoperatively?
  2. What are the common healing complications after tympanoplasty?
  3. Do medical, surgical, or patient factors impact the healing outcomes post-tympanoplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about tympanoplasty is to follow postoperative care instructions carefully, including using any prescribed ear drops as directed. This can help promote optimal healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended for tympanoplasty include those with tympanic membrane perforations (TMP) that have not healed on their own, resulting in hearing loss, recurrent ear infections, or other complications. Patients with chronic otitis media, traumatic perforations, or previous unsuccessful repair surgeries may also be candidates for tympanoplasty. Additionally, patients with conductive hearing loss due to middle ear problems such as ossicular chain discontinuity may benefit from tympanoplasty.

Timeline

Before tympanoplasty:

  1. Patient presents with symptoms such as hearing loss, ear pain, and recurrent ear infections.
  2. Patient undergoes a thorough evaluation by an otolaryngologist, including a physical examination and possibly imaging studies.
  3. Otolaryngologist determines that tympanoplasty is necessary to repair the perforated tympanic membrane.

After tympanoplasty:

  1. Patient undergoes surgery to repair the perforated tympanic membrane, which may include canalplasty.
  2. Postoperatively, patient is prescribed otic quinolone ear drops for healing.
  3. Follow-up appointments are scheduled to monitor healing and address any postoperative issues.
  4. Healing complications such as granulation tissue, bone exposure, and myringitis may occur in some patients.
  5. Hearing outcomes are evaluated at 1 to 2 years postoperatively, with no significant difference in air-bone gap between patients with and without healing issues.
  6. Some patients may experience postoperative issues such as protracted otorrhea, otitis externa, otitis media, and atelectasis.
  7. Overall, suboptimal healing is common after tympanoplasty, with potential for improvement in post-tympanoplasty healing beyond just closing the tympanic membrane perforation.

What to Ask Your Doctor

  1. What is the success rate of tympanoplasty in closing the tympanic membrane perforation?

  2. What are the potential complications or risks associated with tympanoplasty?

  3. How long is the recovery period after tympanoplasty?

  4. What postoperative care measures should be taken to promote optimal healing?

  5. Are there any specific factors that may affect the healing process after tympanoplasty?

  6. How will my hearing be affected after the procedure?

  7. What can I expect in terms of hearing improvement following tympanoplasty?

  8. Are there any lifestyle modifications or restrictions I should adhere to after the surgery?

  9. How frequently should I follow up with my doctor after the procedure?

  10. Are there any signs or symptoms I should watch out for that may indicate a complication or issue with the healing process?

Reference

Authors: Kolb CL, Dirain CO, Antonelli PJ. Journal: Otol Neurotol. 2023 Aug 1;44(7):696-701. doi: 10.1097/MAO.0000000000003919. Epub 2023 Jun 23. PMID: 37367633