Tympanoplasty

WHAT YOU SHOULD KNOW:

Tympanoplasty (Inpatient Care) Care Guide

  • Tympanoplasty is surgery to close a perforated (torn) tympanic membrane and repair your middle ear. Your tympanic membrane (eardrum) is a tissue found in the middle part of your ear. Your eardrum divides your outer ear canal from your inner ear. Tympanoplasty may be needed if your eardrum is completely torn, collapsed, or diseased. You may also need the surgery if your torn eardrum has caused a chronic (long-time) eustachian tube problem. Your eustachian tube connects your middle ear to your throat. Your ossicles (three middle-ear bones) and the bone behind your ear may also be damaged and need repair. How your surgery is done will depend on the type of damage seen in your middle ear.



  • During surgery, caregivers will close your torn eardrum by covering it with a graft. The graft may be placed on the torn portion of your eardrum or used to replace your whole eardrum. If there is damage to any of your ossicles, caregivers will repair them using a different graft. Both grafts may be a piece of skin or cartilage (tough tissue found in joints). The graft may be fascia (hard tissue that covers muscle) or the covering of your cartilage. The graft may be taken from an area of your body, another person, an animal, or man-made. With a tympanoplasty your hearing loss may improve. Your risk of ear infections may also be decreased.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. 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. Your may get blood clots and your eardrum may collapse. Nerves or areas near your inner ear or face may be damaged during surgery. You may develop adhesions (abnormal fibrous connections) in your inner ear or narrowing of your ear canal.

  • You may have hearing loss, otorrhea (excess discharge coming from your ear), 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 develop a new hole in your eardrum after a few years and need another surgery. If you do not have the tympanoplasty, the hole in your ear may get bigger. Your hearing loss may get worse and lead to permanent hearing loss. You may have chronic 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 is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Pre-op care: You may be given medicine right before your surgery. This medicine may help make 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. Your ear and the area around it are cleaned using a germ-killing solution. Sheets are placed around your surgery site to keep the area clean.

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

    • 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 make an incision behind your ear to see your eardrum clearly. Caregivers may also make incisions inside your ear, and above or below your ear. Another incision will be made if your ear graft must be taken from another part of your body.

  • The edges of your torn eardrum will be trimmed, or your entire eardrum may be removed. Damaged ossicles will be repaired with a graft, and any damaged bone behind your ear may be removed. Your caregiver may pack your inner ear with a special sponge before repairing your eardrum. The sponge will help hold your graft in place. A different graft will be used to close your torn eardrum or to replace your eardrum. Another special sponge may be placed on the other side of your graft to secure it. Foam covered with antibiotic (germ-killing) medicine may also be placed in your ear canal. Caregivers will then close your incisions with stitches.

After your surgery:

You will be taken to a room where you can rest until you wake up. 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 in the hospital, you will be taken back to your room. You will have a bandage over your incision to cover your stitches. This bandage keeps the area clean and dry to prevent infection.

  • Medicines:

    • Antibiotics: Antibiotic medicine is given to help prevent infection. This may be taken by mouth or placed in your ear as drops. Antibiotic ear drops may be mixed with steroids, which is medicine to decrease swelling and redness in your ear.

    • Decongestants: You may be given this medicine to help prevent ear pain and dizziness. Decongestants may be used as a nasal (nose) spray or taken by mouth.

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

      • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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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