Myringoplasty

WHAT YOU SHOULD KNOW:

• Myringoplasty, also called tympanoplasty type I, is surgery to fix a perforated tympanic membrane. A perforated tympanic membrane means there is a hole in your eardrum. You may need this surgery if you have chronic otorrhea, which is ear discharge that keeps coming back. A myringoplasty may also be done if you have hearing loss from the hole in your eardrum. During this surgery, caregivers may also need to remove a portion of the bone behind your ear. Removing bone may be done if you have had many past ear infections causing your bone to break down.
  
  
• Caregivers may or may not need to cut open your ear depending on where the hole is located. A graft is used to cover or fill the hole in your eardrum. The graft may be a piece of fascia (hard tissue that covers muscles), skin, fat, or cartilage or its covering. The graft may be taken from another area of your body through a small incision (cut). The graft may also be man-made, from a donor (another person), or an animal. Myringoplasty may help prevent water and germs from entering your inner ear. After your surgery, your hearing may improve and your risk of middle ear infections may be decreased.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

• You may be allergic to the anesthesia used during your surgery. You may bleed more than expected, have pain, and you may get an infection. You may scar in the area your surgery was done, or where your graft was taken from. You may get blood clots and your eardrum may collapse. Nerves or areas near your inner ear or face may be damaged during surgery. If an incision was made in your skin to reach your eardrum, you may take longer to heal. You may develop adhesions (abnormal fibrous connections) in your inner ear or narrowing of your ear canal.
  
  
• You may have hearing loss, otorrhea (excess ear discharge), or myringitis (swelling of your eardrum) after your surgery. Your graft may fail causing you to have an open hole in your eardrum again. You may also develop a new hole in your eardrum after a few years and need another surgery. If you do not have the myringoplasty, the hole in your ear may get bigger. Your hearing loss may get worse and lead to permanent hearing loss. You may have chronic (regular) ear infections. Chronic ear infections may spread to your head, neck, and brain, and may cause death. Call your caregiver if you have questions about your surgery, medicines, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
  
  
• Pre-op care: You may be given medicine right before your surgery. This medicine may help you feel relaxed and sleepy. You are taken on a stretcher to the room where your surgery will be done. You are then moved to a table or bed. Medicine called anesthesia is given to make you comfortable during surgery.
  
  
  • General anesthesia: This is medicine that may be given in your IV or as a gas that you breathe. You may wear a face mask or have a tube placed in your mouth and throat. This tube is called an endotracheal tube or ET tube. Usually you are asleep before caregivers put the tube into your throat. The ET tube is usually removed before you wake up. You are completely asleep and free from pain during surgery.
    
    
  • Local anesthesia: This is medicine that is given as a shot into your skin. It is used to numb the surgery area and dull your pain. Medicine to decrease bleeding may be added to the numbing medicine.

During your surgery:

• Caregivers may look inside your ear using a special scope. Your caregiver may need to remove any earwax present. If your graft will come from your body, your caregiver will cut out tissue from a healthy site. Caregivers may make an incision behind your ear, or inside your ear. Caregivers may make the surface of your eardrum rough so the graft will attach better. Caregivers will check for other ear problems such as damaged bone.
  
  
• A graft is put underneath or over your eardrum to cover the hole. The graft may be secured using a special sponge containing gelatin or special glue. If fat is used as a graft, the fat is plugged into the hole of your eardrum. A bandage soaked in a special paste that prevents germ growth may be placed inside your ear. Caregivers will then close your incisions with stitches.

After your surgery: You will be taken to a room where you will rest until you are awake. Do not get out of bed until your caregiver says it is OK. When caregivers see that you are having no problems, you may be able to go home. If you are staying at the hospital you may then be taken to your hospital room. You will be given antibiotics after your surgery to help prevent ear infections. You may have a bandage over or around your ear. The bandage will help keep your surgery area clean and dry and help prevent infection.

• Medicines:
  
  
  • Antihistamines: This medicine may help prevent symptoms of allergies, such as sneezing or itching.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.
  
  
• Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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