Solution against chronic inflammation and ear damage
Tympanoplasty is a surgical procedure that removes pathology from the middle ear and reconstructs the eardrum and auditory ossicles.
Ear infection is one of those diseases that we have encountered more often, especially in childhood. In most cases, we successfully cured it by consuming antibiotics and resting at home.
Infections of the upper respiratory tract, especially the ear, can be inconvenient. They are often accompanied by ear pain, fever, and in more serious cases dizziness and impaired hearing.
Ear inflammation can be acute and chronic.
Chronic otitis occurs due to recurrent acute inflammation, untreated secretory otitis, perforation of the eardrum.
Chronic otitis is characterized by impaired hearing and occasional leakage from the ear, antibiotic treatment is unsuccessful and requires surgery – tympanoplasty.
Tympanoplasty is a surgical procedure that removes the disease from the ear and reconstructs the eardrum and auditory ossicles in order to restore normal hearing.
The human ear consists of three parts, each of which has a specific function essential for the proper functioning of the upper respiratory tract and nervous system.
The outer ear consists of the auricle and the ear canal that leads to the eardrum. The role of the auricle is to better “collect” signals from the environment, and the ear canal conducts sound to the eardrum. There are also hairs in the outer ear that prevent unwanted objects from entering the ear.
The middle ear is made up of the eardrum, eardrum, mast cells, ear bones, and Eustachian tube. The eardrum divides the middle and outer ear, and its role is to vibrate during the passage of sound signals.
The ossicles of the eardrum, together with the eardrum, form the eardrum. The main role of the eardrum is the chain transmission of the sound signal from the eardrum, through the hammer, anvil and stirrup, all the way to the perilymph, which converts the signal into a nerve impulse.
There is also an Eustachian tube in the middle ear. It connects the ear to the pharynx and serves to equalize the pressure in the ears with atmospheric pressure.
The inner ear, better known as the labyrinth, is made up of the cochlea and semicircular canals. They are part of the so-called vestibular system , which, together with the cerebellum, forms the center for balance. The cochlea and semicircular ducts are filled with endolymph, a fluid that signals a change in body motion.
By moving the fluid along the canal, the receptors inside the labyrinth record these changes in movement and use nerve impulses to instruct the cerebellum to adapt to the situation in which the human body finds itself (standing on one leg, losing balance on a chair, falling off a bicycle, etc.).
Ear injuries can occur due to:
Middle ear infections cause secretions to accumulate in the eardrum. Obstruction of the Eustachian tube prevents the drainage of secretions into the oral cavity and is retained in the middle ear.
The accumulation of secretions puts pressure on the eardrum and can lead to rupture (perforation) of the eardrum. Perforation can be noticed by leakage of secretions from the ear, poorer hearing. Recurrent ear infections more often lead to perforation of the eardrum, thinning of the eardrum, retraction of the eardrum, all of which can result in chronic inflammation.
Perforation of the eardrum can be caused by various mechanical traumas. Some of these traumas happen during strong blows to the head, such as during a fight or shooting a ball.
Still, ear injuries are more likely to happen in the bathroom; Cleaning the ears with cotton swabs can result in irritation of the ear canal and damage to the eardrum.
Sudden changes in pressure put a strain on the eardrums. Changes in altitude (air travel, mountaineering), diving put a lot of pressure on your eardrums; Frequent exposure to these activities can result in wear and tear of the eardrum.
If the skin ingrows into the middle ear through perforation, cholesteatoma is formed, which causes the destruction of the bone structures of the temporal bone.
Tympanoplasty is performed then there is a chronic otitis media.
Chronic otitis is characterized by impaired hearing (conductive hearing impairment) and occasional leakage from the ear. Antibiotic treatment is unsuccessful in most cases.
Surgery (tympanoplasty) removes the disease from the ear, and the function of the ear returns to normal. Chronic otitis can be divided with or without cholestatoma. Chronic inflammation with cholesteatoma is a very serious disease in which the auditory ossicles and surrounding bone structures are damaged and can lead to meningitis, facial paresis, mastoiditis, dizziness… Treatment of chronic inflammation with coelsteatoma is exclusively surgical.
Before we undergo middle ear surgery at the Lohuis Filipović Polyclinic , it is necessary to perform diagnostic examinations in order to gain insight into your health and the condition of your ear.
Since the operation is performed in the presence of general anesthesia, it is necessary to perform examinations with an anesthesiologist, submit a blood count, ECG recording and perform spirometry.
The results of these examinations will be used to observe your vital functions during the operation. In case we notice any deviations, we adjust the procedure and do everything to prevent further complications.
These examinations are typical for almost all surgeries, and for tympanoplasty, the following are also performed:
An ENT examination is considered a basic examination for the diagnosis of any disorders in the ear, throat and nose. When examining the ear, the doctor uses an endoscope with the help of which he can see the details on the eardrum and assess which disease it is.
Otomicroscopic examination allows for a detailed view of the eardrum and the detection of middle ear pathology.
If you notice hearing loss, you will be subjected to various hearing tests, of which a tonal audiogram examination stands out.
When performing this examination, go to a quiet room where sounds of various frequencies will be emitted through your headphones. Whenever you hear a sound, you’ll signal it through a given device, which automatically creates a graphical representation of your hearing threshold.
Tympanometry determines the condition of the eardrum and the mobility of the auditory ossicles. A device that is placed in your ear canal provides information about the transmission of sound energy through the middle ear and the change in pressure inside it.
This examination is not used to check hearing, but to make changes in the functionality of the middle ear segments. Changes in the ear, such as perforation, can indicate hearing loss, but with other examinations (audiometry).
After the examination and diagnosis, you will receive instructions that you need to follow in order for the procedure to go without complications and for recovery to be as fast as possible.
After the examinations and the results are submitted, you will need to sign a consent that describes in detail the procedure of the operation, possible risks and information on the use of general anesthesia.
By signing the consent, you accept all possible risks and the use of anesthetics.
Be sure to come to the surgery accompanied. Namely, the effect of general anesthesia is present even a few hours after the end of the operation. You may feel mild nausea and lightheadedness, which is why driving after surgery is undesirable.
After admission to the polyclinic, the medical staff will place you in your room, and then on the operating table. The anesthesiologist will give you general anesthesia. Due to the action of general anesthesia, the operation will be painless and you will not remember it.
With an operating microscope , the doctor removes the pathology from the ear and performs the necessary reconstruction of the eardrum and auditory ossicles. Depending on the extent of the disease, the operation is done through the ear canal or behind the ear.
Auditory ossicles that have been destroyed by the disease can be replaced with titanium prostheses, and the eardrum is reconstructed with the help of perichondrium, temporal muscle fascia and cartilage.
The disease can spread to the personal nerve and cause paresis of the facial nerve, that is, if it spreads to the inner ear, deafness will occur. If the disease spreads to the brain, the development of meningitis is possible.
The operation takes between 1-3 hours.
After the operation, the anesthesiologist wakes you up from your unconscious state and you go to home care the same day.
Recovery after tympanoplasty depends on the severity and type of surgery performed.
A few days after the procedure, you may feel mild dizziness. Mild pain will be present at the incision site behind the ear, and slight bleeding is possible.
The first check-up after the operation is on the seventh day when the sutures are removed, after a month the resorptive material is removed from the ear canal and the condition of the new eardrum is assessed.
You will feel as if your ear is blocked and you will notice a slightly weaker hearing. This side effect is normal and usually goes away 3-4 weeks after surgery.
Although your hearing will improve over time, full recovery occurs only after 3-6 months.
Avoid any strain and increased physical activity. You are allowed to do lighter activities, such as walking, and you will increase the intensity over time.
Avoid activities that put pressure on your ear: swimming, scuba diving, mountaineering, or traveling by plane.
When showering, try not to wet your ear.
You are allowed to eat food that you normally eat without any special restrictions. Try to consume as much fluid as possible.
Initially, you should avoid alcohol consumption, which can cause increased dizziness.
You can use painkillers, but avoid those that thin the blood (Andol, Aspirin).
After tympanoplasty, you can expect standard side effects that are typical for any procedure such as bleeding, infection or an allergic reaction to anesthesia.
However, tympanoplasty can cause some other complications:
If you notice any of these side effects, be sure to inform us so that we can arrange an examination and a possible repetition of the procedure.
At the Lohuis Filipović Polyclinic , we perform ear, throat and nose surgeries on a daily basis. Our team of ENT specialists and neck and head surgery will make sure that the procedure goes smoothly and that you leave our office healthier and more beautiful.
Middle ear surgery is the optimal solution for treating chronic otitis. The procedure is quick and painless, and if done correctly, complications are rare.
If you suspect a possible perforation of the eardrum, make an appointment for an examination by calling +3851 2444 646 or fill out our online form.
The main goal of LF Polyclinic is to improve the quality of life and health of our clients by providing them with top-notch healthcare services.
