Tympanic Membrane Perforation / Tympanoplasty
Eardrum perforation is a hole in the eardrum that is most often caused by a middle ear infection. It can also be caused by a sudden change in pressure caused by a loud noise, flying in an airplane or an object placed in the ear. If an object penetrates the eardrum, it can also sometimes fracture the small bones called ossicles within the inner ear. This condition frequently occurs in children, as they are most affected by ear infections.
Eardrum perforation causes severe pain and can also result in bleeding from the ear and hearing loss. The hearing loss can be severe if the ossicles are broken. A perforation is diagnosed by a doctor simply looking in the ear with a special instrument called an otoscope. A hearing test is also performed to verify hearing loss.
Tympanoplasty - Treatment for Eardrum Perforation
Minor eardrum perforations often do not need any treatment, as the hole will close by itself within a few days. Medication or ear drops may help clear lingering infections before the hole closes itself. If the perforation persists for more than three months without a corresponding infection, surgical treatment may be necessary.
Tympanoplasty is a reconstructive procedure performed to repair torn tympanic membranes or ossicles and help restore hearing, treat certain types of deafness, and prevent middle ear infections. Your doctor will decide whether or not surgery is the right choice for you based on an evaluation of your age, history of infections, overall health and other factors.
During the tympanoplasty procedure, the hole in the eardrum is closed with a patch of tissue, called fascia, taken from behind the ear. An incision is made behind the ear and the ear is moved forward to expose the eardrum. The hole in the eardrum is thoroughly cleaned before the graft tissue is cut and placed under the hole to repair the eardrum. The normal skin of the eardrum will grow across the hole over time.
This procedure is performed with the operating microscope under general anesthesia. Outpatient surgery may be possible for older children and adults or an overnight stay in the hospital when needed.
A mastoidectomy is the surgical removal of an infected portion of the mastoid bone (the prominent bone behind the ear) when medical treatment is not effective. The need for this surgery has diminished with improved medical care and the use of antibiotics.
Mastoidectomy is performed to remove infected air cells within the mastoid bone caused by mastoiditis, ear infections, or cholesteatoma (an inflammatory disease of the middle ear). The air cells are open spaces containing air (similar in appearance to a honeycomb) that are located throughout the mastoid bone. They are connected to a cavity above the eardrum in the upper part of the bone which is connected to the middle ear. Infections in the middle ear can therefore spread through the mastoid bone, making surgery necessary if antibiotics do not work. A mastoidectomy may also be performed to repair paralyzed facial nerves.
Stapedectomy is a surgical procedure in which the innermost bone (stapes) of the three middle ear bones is removed and replaced with a prosthesis (a small plastic tube surrounding a stainless-steel wire). This is performed to improve the movement of sound to the inner ear. Stapedectomy is usually performed as an outpatient, same day surgery.
A stapedectomy treats progressive hearing loss caused by otosclerosis, a condition in which spongy bone hardens around the base of the stapes. Otosclerosis causes the stapes to adhere to the opening of the inner ear, preventing the stapes from vibrating properly and disrupting the transmission of sound to the inner ear. If otosclerosis remains untreated, it can progress to complete deafness.
Chronic Ear Infection (Otitis Media)
An ear infection, also known as otitis media, is a very common condition that develops as a result of dysfunction of the Eustachian tubes, which connect the ear to the nose. Patients with an ear infection may experience earache, hearing loss, fever, ear discharge, headache and dizziness.
Most ear infections go away on their own within two or three days. But some patients may experience chronic ear infections, which involve long-term damage to the middle ear from frequent infection and inflammation. To diagnose a chronic ear infection, your doctor will examine the affected ear. In some cases, a sample of ear fluid may be taken to check for the presence of bacteria.
Chronic ear infection treatment may include antibiotics to fight a bacterial infection and steroids to reduce swelling. Depending on the severity of the condition, surgery may be necessary to remove tissue or bone that has become infected, repair damage to the middle ear bones, repair a hole in the eardrum or place ventilation tubes to prevent fluid from accumulating again.