Hearing problems can occur for various reasons, and in some cases the essence of the disease is reduced to the deterioration of the middle ear. In order to restore it, tympanoplasty is used - an operation during which the eardrum itself is directly reconstructed. This form of treatment has repeatedly proved its effectiveness.
The essence of the problem
When it comes to such a form of surgical intervention as tympanoplasty (surgery on the middle ear), a specific technique for the treatment of chronic purulent otitis media in the region of the eardrum is implied. It is important to note that this effect is complex and has a significant restorative effect, allowing you to reconstruct the middle ear.
It makes sense to pay attention to the fact that chronic otitis media is diagnosed quite often. It leads to the formation of a hole in the eardrum, which is called perforation. For this reason, it becomes possible the penetration of pathogenic bacteria into the tympanic cavity, which, in turn, leads to the release of pus, which can be disturbing for more than one year.
Tympanoplasty is an operation without which purulent otitis media will be extremely difficult to overcome. In addition, a neglected disease of this type can result in the occurrence of an abscess and thrombosis of cerebral vessels, and in some cases, meningitis.
Indications for surgery
There are a number of conditions under which the surgery mentioned above is necessary. The bottom line is about the following health problems:
- the formation of regional or central perforation of the eardrum, which becomes the cause of the displacement of the auditory ossicles;
- polyps developing in the middle ear;
- tympanosclerosis;
- perforation of the eardrum, not accompanied by inflammatory processes;
- fibrosis of the middle ear.
Obviously, there are many reasons why surgery may be relevant.
Contraindications
It is important to understand that there are cases when ear surgery (tympanoplasty) cannot provide the desired effect. Here are the diagnoses in which the use of such a technique is strongly discouraged:
- exacerbation of chronic diseases;
- adhesive otitis media;
- complete deafness;
- severe general condition of the patient;
- sepsis and purulent complications.
Sanitizing surgery on the middle ear with tympanoplasty is also contraindicated in the case when a persistent violation of the patency of the auditory tube is recorded. Congenital malformations, as well as scars, and adhesions resulting from inflammation can be attributed to this category.
Relative indications
In this case, we are talking about those diseases against which the operation is undesirable, but possible. In this case, the final decision will be made by the doctor, based on his experience and the condition of the particular patient. So, the contraindications themselves:
- An acute inflammatory process in the middle ear;
- Allergic diseases in the acute stage;
- problems with the upper respiratory tract;
- epidermisation process.
Only taking into account all the contraindications described above, you can prescribe such a treatment as tympanoplasty. Reviews after surgery are an important sign of the quality of treatment, so you should always be interested in the opinions of patients about a particular clinic. Forums can help with this.
It is worth remembering that the doctor is obliged to examine the other ear and make predictions about the risk of damage to it. After that, a decision will be made regarding the operation on the second eardrum.
A full examination of a general nature should also be carried out: coagulorama, biochemical and general analysis of blood and urine, as well as a blood test for syphilis, HIV, hepatitis B and C. The examination program also includes an ECG.
Surgical preparation process
Before surgery, a conservative treatment is performed, which is designed to prepare the ear for tympanoplasty. Various means are introduced into the cavity of the middle part where the eardrum is located, designed to have an anti-inflammatory, vasoconstrictive and antibacterial effect. All of them have a wide spectrum of action.
Such procedures are very important because they allow you to clean the operated area from infection. Thanks to this procedure, safe tympanoplasty becomes possible. Responses after surgery, respectively, will also be predominantly positive, since sanation (cleaning) initially blocks the effect of infection on the middle ear, and subsequently contributes to the rapid healing of the postoperative wound.
Moreover, such a measure leads to an improvement in the patency of the auditory tube, which has the most direct impact on the quality of the result of the surgical intervention.
If the patient has chronic diseases, then it is necessary to consult a specialized doctor. 7 days before the operation is performed, you need to refuse to take the funds used to thin the blood. We are talking about non-steroidal anti-inflammatory drugs (Paracetamol, Aspirin) and Warfarin.
Types of exposure
There are various methods that allow you to get a significant improvement in the condition of the middle ear after surgery. Tympanoplasty for this reason can also be performed in different ways. It makes sense to highlight three key areas:
- Recovery using ossiculoplasty . Actually for those patients in whom the auditory ossicles were damaged due to a serious inflammatory process, and their rehabilitation is possible only with the help of prosthetics. In this case, materials such as titanium, cement and plastic are used.
- The essence of the second type is to close the tympanic membrane through the own tissues of the middle ear . The most common and least complex is precisely such a tympanoplasty. Reviews after surgery of this type in the vast majority of cases are positive.
- Meringoplasty without prosthetics. It is used to treat patients with damaged auditory ossicles, but dentures are not used. To restore enough native bone tissue.
Sometimes doctors are faced with a problem such as the fusion of two surfaces of the middle ear, which is caused by a complication after otitis media. In this case, both grafts and the eardrum itself, more precisely, its remains, are used to restore the tympanic cavity.
Rehabilitation period
In order for the feedback after surgery to be positive when using a treatment method such as tympanoplasty, it is necessary to organize a high-quality recovery of the patient.
First of all, this is a stay for 1-3 days in a hospital. Rehabilitation includes the use of antibiotics during the first postoperative week. Along with these restorative measures, daily anemia is important. This means the introduction of vasoconstrictor drugs into the pharyngeal mouth of the auditory tube.
Since the release of the auditory canal from tampons occurs gradually, at first the patient should come for examinations on an ongoing basis.
To normalize as soon as possible after surgery, you need to sneeze less, blow your nose and protect your auricle from getting water in it. For effective methods of protecting against moisture while taking a shower, it is best to consult your doctor. The lifting of heavy objects will also have to be abandoned. In fact, it is necessary to exclude any loads that can cause strong tension in the middle ear.
Possible complications
If we consider all the facets of surgical intervention, it is worth noting that there are certain risks during the procedure such as tympanoplasty. Complications after surgery can be completely different: damage to the labyrinth, tympanum, facial nerve, and even the dura mater. The latter, by the way, sometimes causes bleeding from the jugular vein or otoliquorrhea.
It is also worth paying attention to the risk of aseptic ear inflammation in the postoperative period. This condition, as a rule, is accompanied by discharge, swelling and pain.
Sometimes, after tympanoplasty surgery, suppuration in the ear may appear. Reviews confirm the fact that a similar problem has a place to be. For this reason, the stationary regimen is important during recovery, because with possible complications, doctors will be able to provide qualified and timely assistance.
Complications of a general nature can also include a prolonged headache (consequences of the labyrinth fistula), imbalance and dizziness.
What about transplants?
Those who underwent surgery with the use of prosthetics need to follow the recommendations of doctors exactly, because in case of inflammation of the middle ear, the process of rejection may begin.
The fact of inflammation will also affect the speed of recovery. After using tympanoplasty using prostheses, there is a risk of displacement of the latter, as well as necrosis or atrophy. So, if prosthetics took place, you need to take care of yourself thoroughly.
Hearing loss
The manifestation of hearing loss in the operated ear, which can reach the level of complete deafness, belongs to the group of complications. Such a problem makes itself felt after conducting complicated or non-radical tympanoplasty. Impairment of sound perception is sometimes the result of reactive labyrinthitis, which can pass without medical procedures. If this does not happen, then competent therapy under the supervision of a doctor will help to neutralize this problem.
Thus, it must be understood that hearing impairment caused by labyrinthitis is temporary and can be treated.
But the good news is that such complications are observed only in 3% of patients who underwent surgery. Tympanoplasty reviews It is mostly positive, so you should not be afraid of this technique.
Short-term paralysis
This is another complication that may appear after surgery on the middle ear. The good news is that the nature of this problem is temporary. The cause of short-term paralysis is postoperative edema of the facial nerve.
In some cases, this nerve may be damaged due to intraoperative crossing. As a recovery measure, plastic is used. It is about suturing the subcutaneous nerve of the neck. In an alternative embodiment, the facial nerve is crosslinked with the sublingual. With such an intersection during surgery, even after plastic surgery, there remains a risk of retaining residual muscle weakness in the face.
Reviews
If we study the comments of people who decided to reconstruct the middle ear, we can conclude that this treatment technique is very effective.
Most advise to decide on such measures for chronic otitis media, since in their case the problem was solved only after the operation "tympanoplasty". When a full recovery occurs, one cannot say for sure in view of the possible complications and characteristics of the organism of each particular patient.
But if we talk about average indicators, then the ear returns to normal after a month from the day of surgery.
Summary
Chronic otitis media is a rather serious disease, and if you start it, then damage to the middle ear can be significant. Tympanoplasty, in turn, allows you to completely neutralize this problem and restore the eardrum. In addition, the operation itself lasts about an hour. Thus, there is no reason to ignore this treatment.