A surgical technique to repair a defect in the tympanic membrane, Tympanoplasty begins with the placement of a graft, either medial or lateral to the tympanic membrane annulus. This surgical procedure not only closes the perforation but also improves hearing. The success of the operation is judged by the ability to eradicate the disease from the middle ear (eg, inflamed granulation tissue and cholesteatoma). Various techniques and materials have been developed and refined over the years to improve the overall quality of results.
A child’s perforated eardrum, which is a hole in the eardrum, is repaired via a procedure called pediatric tympanoplasty. A thin membrane deep in the ear canal, the eardrum is a membrane vibrates when sound waves hit it and help transfer sound energy into the inner ear. This entire process allows us to hear.
Causes of a hole in the eardrum can be from a bad ear infection, a surgical procedure, or from trauma such as a foreign object jabbed deep inside the ear canal (one of many reasons to avoid using any cotton swab to clean your ears.
A physical examination by a pediatrician or family doctor 7 days before surgery is essential to make sure the child is in good health. A complete the History and Physical form provided by the office must be filled in diligently to ensure a successful surgery.
Transcanal and post auricular are the two major approaches to the eardrum. The postauricular approach involves an incision made behind the ear whereas, in the transcanal approach, a speculum is placed in the outer opening of the ear canal to visualize through the speculum.
On achieving a full view of the eardrum, the margins around the perforation are freshened with an instrument. Removing the rim around the perforation produces a raw circumferential edge of the remaining eardrum. Incisions are then made in the ear canal skin; this elevates part of the ear canal skin along with any remnant of good. The fascia is laid into the ear to cover the perforation on the underneath side of the eardrum. The canal skin is put back in place; the ear canal is packed and a cotton ball applied. A four to six week period is to be expected for complete healing.
1 to 2 hours are typically required for completing tympanoplasty. Post-surgery, a child may require close to 45 minutes to an hour to wake up. Once awake, he or she will be led to a Short Stay post-operative area to complete recovery.
Most Children can go home on the same day of surgery. However, in rare cases, an overnight stay may be required (e.g., your child has excessive nausea or vomiting). In case of the overnight stay, a child should be accompanied by one parent. Be aware that bloody discharge or drainage from the ear canal for a few days after surgery is normal and is not a cause for alarm.
Symptoms like ear pain and soreness are common after surgery but should go away during the first 3 to 5 days. Pain medicine may be prescribed depending on a case-to-case basis for the first few days after surgery.