What is Tympanoplasty Surgery?
Tympanoplasty is a surgical procedure aimed at repairing a perforated eardrum (tympanic membrane) and, in some cases, the small bones of the middle ear. A perforation may result from chronic ear infections, trauma, or previous surgeries. The tympanoplasty procedure involves closing the hole in the eardrum with a graft, which can help restore hearing, prevent infection, and improve hearing.
What are the Different Types of Tympanoplasty Surgeries?
There are various tympanoplasty types, each addressing specific conditions of the ear. The surgery is classified into five types (Type I to Type V), depending on the extent of damage and structures involved. The choice of tympanoplasty type depends on the patient's ear condition, age, and hearing level.
Type I Tympanoplasty (Myringoplasty)
In cases where only the tympanic membrane is perforated, this procedure involves repairing just the eardrum. With the ossicular chain intact, sound conduction remains undisturbed.
In situations involving damage to both the eardrum and the malleus, this type provides reconstruction by connecting the graft to the incus or remaining malleus parts. As a result, continuity of sound transmission is restored.
In the presence of more extensive ossicular damage, particularly affecting the incus, the graft is placed directly onto the stapes head. Through this approach, the hearing mechanism is preserved despite greater bone loss.
In cases where only the stapes is functional and the rest of the ossicles are absent or eroded, the graft is strategically positioned to shield the round window. By doing so, sound is directed efficiently through the remaining structure.
In rare instances where the stapes is fixed and non-functional, this procedure involves creating a new window in the inner ear. With this bypass route, limited sound transmission can still be achieved.
Who Needs Tympanoplasty Surgery?
People who experience repeated ear infections, hearing loss, or a ruptured eardrum may need tympanoplasty surgery. Consulting an ENT specialist is essential to determine if tympanoplasty is necessary. An eardrum rupture may require surgery if:
The eardrum does not heal naturally after injury or infection.
There's conductive hearing loss.
Chronic drainage from the ear doesn’t respond to medication.
The person experiences frequent earaches or discomfort.
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When Should I Consult the ENT Doctor for Tympanoplasty Surgery?
In cases of persistent eardrum perforation that does not heal on its own within several weeks or months, it is advisable to seek evaluation by an ENT specialist. In addition to ongoing ear discharge (chronic otorrhea), hearing loss, or recurrent ear infections, consulting a doctor becomes important to prevent further complications.
Symptoms such as persistent eardrum perforation, ear pain, decreased hearing, dizziness, persistent ear discharge, etc., are essential to determine if tympanoplasty or other interventions are necessary. Early consultation with the ENT doctor ensures proper diagnosis and planning for surgery to restore ear function and protect against infections.
How to Prepare for Tympanoplasty Surgery?
Proper preparation before the surgery improves surgical outcomes and reduces the risk of complications during the surgery. Here’s how the patient can prepare for the tympanoplasty surgery:
Medical Evaluation and Diagnostic Tests
Before the surgery, a comprehensive medical evaluation is done by the doctor, including hearing tests (audiometry) and sometimes imaging like a CT scan. These help the ENT doctor understand the extent of ear damage and plan the surgery precisely.
Patients are usually advised not to eat or drink anything for 6 to 8 hours before the surgery to reduce the risk of complications due to anaesthesia. Following these fasting guidelines ensures your safety throughout the procedure.
It is important to inform the doctor about all the ongoing medications. Certain drugs, especially blood thinners or herbal supplements, may need to be stopped temporarily to minimise bleeding risks during surgery.
Existing Medical Conditions
Sharing details about chronic illnesses like diabetes, hypertension, or respiratory issues is crucial. Proper management of these conditions before surgery helps prevent complications and supports a smoother recovery.
History of Allergic Reaction to Anaesthesia
Inform your doctor of any previous allergic reactions to anaesthesia or other medications should be communicated to the surgical team. This allows anesthesiologists to choose the safest anesthesia method tailored to your needs.
On the day of surgery, wearing loose, comfortable clothing that is easy to remove is recommended. Avoid wearing jewellery, makeup, or accessories to maintain cleanliness and prevent interference during the procedure.
What Happens During Tympanoplasty Surgery?
Tympanoplasty is usually performed under general anaesthesia and takes 1 to 2 hours. It is a daycare procedure, which means the patients usually go home on the same day of the surgery, after the doctor’s consultation. Here is how the tympanoplasty procedure is performed:
Administration of Anaesthesia
The surgery usually begins with general anaesthesia (especially for children) or local anaesthesia with sedation for adults. This ensures the patient is comfortable and pain-free throughout the procedure.
Cleaning and Preparation of the Ear
The surgical area is thoroughly cleaned and sterilised. A microscope or endoscope is used to provide a detailed view of the middle ear structures for precise surgical work.
An incision is typically made behind the ear (postauricular approach) or inside the ear canal (endaural approach) to reach the eardrum and middle ear. The choice of approach depends on the extent and location of the damage.
Harvesting the Graft Tissue
A small piece of tissue, often taken from the patient’s own tragus (a part of the outer ear) or fascia (connective tissue behind the ear), is prepared to be used as the graft to repair the eardrum.
Repairing the Eardrum and Ossicles
Depending on the type of tympanoplasty, the surgeon repairs just the eardrum or also reconstructs the tiny middle ear bones (ossicles). The graft is carefully placed over the perforation or on the ossicles as needed.
The graft is positioned in place using special techniques and may be supported with gel foam or packing material to hold it steady while healing begins.
Once the repair is complete, the incision (if made behind the ear) is closed with sutures. A sterile dressing is applied to protect the area and absorb any drainage.
What to Expect After Tympanoplasty Surgery?
Tympanoplasty is an effective procedure to restore hearing and resolve chronic ear issues. After the surgery, it’s natural to experience certain changes and symptoms as your body begins to heal. Here is what you can expect after the surgery:
After the procedure, the patient will be taken to the recovery area until the effects of anaesthesia wear off. Vital signs like heart rate and blood pressure are closely monitored to ensure stability.
The operated ear will be covered with a protective dressing or cotton wick to absorb any drainage. It’s important to keep the ear dry and avoid touching or disturbing the dressing until your doctor advises otherwise.
Mild discomfort or pain around the ear is common and can be managed with prescribed painkillers. Following the medication schedule helps maintain comfort during the initial healing phase.
Rest is crucial after surgery, and strenuous activities, heavy lifting, or bending over should be avoided for several days. Keeping your head elevated while resting can help reduce swelling and promote healing.
Scheduled visits to the ENT doctor will be necessary to monitor healing and remove any packing or stitches. These follow-ups help ensure the surgery was successful and address any concerns promptly.
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What are the Benefits of Tympanoplasty Surgery?
Tympanoplasty can significantly improve the quality of life. The main benefits include:
One of the primary benefits is the restoration or significant improvement of hearing by repairing the perforated eardrum and reconstructing the middle ear bones. This helps sound waves transmit effectively to the inner ear.
Prevention of Recurrent Infections
By closing the perforation in the eardrum, tympanoplasty reduces the risk of chronic ear infections and persistent ear discharge, protecting the middle ear from bacteria and other harmful agents.
Protection of the Inner Ear
A repaired eardrum acts as a barrier that shields the middle and inner ear structures from water, dust, and pathogens, which helps preserve overall ear health.
With better hearing and fewer infections, patients often experience improved communication, less discomfort, and greater confidence in daily activities.
Preventing Further Complications
Timely surgery can prevent complications like cholesteatoma (abnormal skin growth in the middle ear) and hearing loss, thereby safeguarding long-term ear function.
What are the Recovery Tips after Tympanoplasty?
Recovery from tympanoplasty can take 4 to 6 weeks, depending on the individual and the complexity of the procedure. Here are some recovery tips that can help you recover faster after the surgery:
Avoid getting water into the operated ear while bathing or washing your hair. Use a shower cap or a cotton ball coated with petroleum jelly to protect the ear.
Take Medications as Prescribed
Complete the full course of antibiotics and take pain relievers as directed by your doctor. This helps manage discomfort and prevent infection.
Refrain from lifting heavy objects, bending over, or doing intense physical activity for at least a week or until cleared by your ENT doctor.
Do Not Blow Your Nose Forcefully
Blowing your nose hard can create pressure in the middle ear and affect healing. If you must sneeze, do so with your mouth open to reduce ear pressure.
Elevate Your Head While Resting
Sleeping with your head slightly elevated can reduce swelling and improve fluid drainage from the ear.
Avoid Flying and Swimming
Stay away from air travel, scuba diving, or swimming for a few weeks post-surgery, as pressure and water exposure can harm the healing ear.
Attend All Follow-Up Visits
Regular check-ups allow your doctor to monitor the healing process, remove packing if used, and address any issues early.
Monitor for Warning Signs
Watch for symptoms like fever, increasing pain, persistent discharge, or dizziness. If any of these occur, contact your doctor immediately.
Do’s and Don’ts after Tympanoplasty Surgery
Do’s:
Keep the ear dry at all times; use a shower cap or earplugs while bathing.
Take all prescribed medications, including antibiotics and painkillers, exactly as directed.
Rest with your head elevated on pillows to reduce swelling and discomfort.
Attend all scheduled follow-up appointments for proper monitoring and care.
Report any unusual symptoms immediately, such as severe pain, fever, dizziness, or discharge from the ear.
Don’ts:
Avoid inserting anything into the ear canal, including cotton swabs or fingers.
Refrain from heavy lifting, bending over, or strenuous exercise for at least a week or as advised.
Do not fly or travel to high altitudes soon after surgery, as pressure changes can affect healing.
Avoid smoking and exposure to secondhand smoke, which can delay recovery.
Steer clear of loud noises or environments that may irritate your healing ear.
Choose Artemis Hospitals for Advanced Tympanoplasty Surgery in Gurgaon
Artemis Hospitals are nationally and internationally known for providing good, affordable and reliable treatment for the entire spectrum of ENT diseases and disorders. Our team of ENT doctors are adept at performing all routine as well as complicated procedures of the ear, nose and throat.
The department of ENT at Artemis is an all-inclusive, comprehensive unit with a list of diagnostic and therapeutic options under the same roof. A set of detailed tests and evaluations undertaken by a team of proficient ENT Surgeons and Audiologists determines the further course of action. We provide excellent state-of-the-art patient care in a supportive environment and conduct educational programs that provide excellent training in research and clinical care.
Our Services
Airway surgeries like laryngotracheal reconstruction
Endoscopic Ear Surgeries
Incisionless stapedotomy
Paediatric Otolaryngology
Rhinology
Otology
Laryngology & Voice Clinic
Cochlear Implant
Audiology and speech therapy
Allergy Clinic and Immunotherapy
Swallowing Therapy
Vertigo Clinic
To book an appointment with top ENT surgeons at Artemis Hospitals, call our customer care at +91-124-451-1111 or WhatsApp us at +91 9599285476. You can also schedule an appointment through our online patient portal or download and register on the Artemis Personal Health Record mobile app, available for both iOS and Android devices.
Reviewed By Dr. Poonam Gautam
Sr. Consultant - ENT & ENT Surgery
Artemis Hospitals
Frequently Asked Questions
Is tympanoplasty a painful procedure?
No, the surgery is performed under anaesthesia. Post-operative pain is usually mild and can be managed with medication.
Can tympanoplasty restore complete hearing?
It often improves hearing significantly, but the extent depends on the damage to the middle ear and the type of surgery.
How long does tympanoplasty surgery take?
Tympanoplasty surgery usually lasts between 1 to 2 hours, depending on the complexity of the condition, the medical health of the patient, and the surgical expertise of the ENT surgeon.
Will I have a visible scar after surgery?
A tiny incision is made behind the ear, which may not be very visible and is usually minimal and well-hidden. However, the size of the scar depends on the surgical expertise of the surgeon.
Is tympanoplasty permanent?
In most successful cases, yes. However, repeated infections or trauma can compromise the results.
Can I fly after tympanoplasty surgery?
Flying should be avoided for at least 4–6 weeks, or until your ENT doctor approves.
Whom should I consult for tympanoplasty surgery near me?
Consult an ENT surgeon specialising in diagnosing and treating conditions related to hearing disability. Artemis Hospitals has some of the best ENT surgeons who specialise in performing tympanoplasty surgery in Gurgaon with a high success rate.
What factors impact the tympanoplasty surgery cost in Gurgaon?
Tympanoplasty surgery cost is influenced by factors such as the type of surgery, hospital fees, the technique used, the surgical expertise of the surgeon, and diagnostic tests. To get a cost estimate, contact us to book an appointment with some of the best ENT surgeons in Gurgaon.
How do I book a consultation for cochlear implant evaluation at Artemis Hospitals?
To book an appointment with top ENT surgeons at Artemis Hospitals, call our customer care at +91-124-451-1111 or WhatsApp us at +91 9599285476. You can also schedule an appointment through our online patient portal or download and register on the Artemis Personal Health Record mobile app, available for both iOS and Android devices.
Can tympanoplasty be done on both ears?
Yes, but doctors do not usually recommend operating on both ears at the same time. One ear is treated first, followed by the other after recovery.
