Tympanoplasty in Spain

Treatment and Cost

10

Total Days
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2 No. Travelers

2 Day in Hospital

8 Days Outside Hospital

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About the Tympanoplasty

People from all age groups can get affected by ear disorders and hearing impairment problems. In the United States, a survey revealed that under the age of 65, over 60 per cent of the population suffers from problems related to hearing loss. However, almost 25 per cent of people aged above 65 experience a significant loss of hearing. Thankfully, different types of ENT surgeries are available to treat problems related to the ear.

Most often, people are diagnosed with problems related to the eardrum, or tympanum, and the infection in the cells of the mastoid bone. The tympanum is the thin membranous structure present between the outer and the middle ear. It vibrates when sound waves hit on it and this enables us to hear.

A repair surgery called tympanoplasty is required to treat a perforation or hole in the eardrum. The middle ear is sterile but due to rupture of the eardrum, an infection can also occur. It may also be required for repairing of tiny bones present behind the eardrum or ossicles in the mastoid bone. This repair is known as mastoidectomy.

Tympanoplasty and mastoidectomy are therefore conducted together in many cases. This procedure is known as tympano-mastoidectomy.

Causes of Hearing Loss

There are several reasons that may cause loss of hearing, including the following:

  • Birth defect

  • An ear infection that has grown very severe and left untreated for long

  • The injury suffered by the ear

  • Ear subjected to excessive levels of noise

  • Hearing loss as a result of age

  • Other reasons

Symptoms of Hole in Eardrum

Some of the common symptoms of a puncture in eardrum include the following:

  • Sharp pain in the ear that disappears abruptly

  • Excessive pressure, which will suddenly disappear with the rupture and pus formation in the ear

  • Loss of hearing

  • Dizziness

Types of Tympanoplasty

Type 1 tympanoplasty or myringoplasty is the surgery that ensures restoration of the eardrum that got perforated with drafting

Type II tympanoplasty addresses membrane perforations with erosion in the bone malleus. Grafting is done on the incus bone or in the remains of the malleus.

Type III tympanoplasty is meant for destruction of two ossicles and intact and mobile stapes bone. A graft is placed on the stapes and it provides protection for the total assembly.

Type IV tympanoplasty is useful for cases of ossicular destruction, which has all or part of the arch of stapes included. A graft is placed around the mobile stapes footplate

Type V tympanoplasty is useful when the footplate of the stapes bone is fixed. 

For treating Cholesteatoma, tympanoplasty can be combined with stapedectomy and mastoidectomy and in many cases, a second operation is required to ensure the infection is totally eradicated.

How is Tympanoplasty performed?

The tympanoplasty surgery is performed with intravenous sedation and local anaesthesia. An incision is made into the ear canal section and from the bony ear canal, the remaining eardrum is elevated and lifted forward. Under the operating microscope, the ear structures can be seen clearly. An incision behind the ear is made if the hole is very large or far forward. It ensures that the entire outer ear is forwarded, giving better access to the perforation.

The perforated remnant part is rotated forward after the hole is exposed and now the ossicles are inspected. Scar tissue and bands can surround the bones and they are removed with a laser or micro hooks. Now the ossicular chain is pressed to check its mobility and functionality. If it is found to be mobile, then the rest of the surgery aims at repairing the defect of the drum.

From the tragus, which is the cartilaginous lobe of skin in front of the ear, or from the back of the ear, a tissue is taken. A gelatin sponge is positioned under the drum, which is absorbable and it supports the graft. Underneath the remaining drum remnant, the graft is inserted and folded back to close the perforation. The incision is closed with the help of stitches. On the outside of the ear canal, a sterile patch is placed and the patient can then be transferred to the recovery room.

If the bones in the ear suffer from erosion, then ossicular reconstruction is advised. At times it can be determined before surgery but in other cases, erosion is visible only when the ear is completely opened under the microscope.  The reconstruction can happen at the time of the eardrum construction. Bone erosion can happen at the tip of the incus or anvil. A discontinuity between stapes and the incus has to be resolved.  

A small piece of bone or cartilage can be inserted from some other part of the body of the patient if the gap between the two cones mentioned above is small. But if the gap is large, then the anvil bone is removed and remodelled to give a shape of a tooth with the help of the operating microscope. After reshaping the prosthesis, it is placed between the malleus and the stapes and ossicular chain continuity is then re-established.

In some other ossicular construction, the malleus can get fixated by bony ingrowth or scar tissue to the ear’s lateral wall.  The plastic-type or silastic sheet is often placed to prevent the regrowth of a new bone against the wall.  In such a reconstruction, it may be required that the stapes and incus are separated from the natural connection to stop the transmission of drill vibration. This can damage the inner ear.

Recovery from Tympanoplasty

Usually, a patient is discharged within two to three hours of the surgery. Along with a mild pain reliever, some antibiotics are also administered. After 10 days, the patient is again expected to visit so that packing can be removed and graft success can be checked.

Patients are advised to keep water away from the surgical site and avoid blowing of the nose. If the patient is suffering from cold and allergies, then decongestants are prescribed. Within 5 to 6 days, the patients can resume a normal life. After 3 weeks of the surgery, the packing is removed under the operating microscope and at this point, the grafting success can be completely determined. 

Care must be taken by the patient to soak the ear canal with antibiotics to keep infection at bay. Shearing forces of excessive tension should not be felt by the graft. The surgeon will advise the patient to avoid activities that alter the tympanic pressure, including using a straw to drink or blowing of the nose. Finally, a hearing test is performed after 4 to 6 weeks of the surgery.

Patient Stories

Frequently Asked Questions

What is the health care infrastructure of Spain / Why should opt for Spain as a destination for your medical treatment?
Spain has a uni payer healthcare system. This means that there is universal coverage for most of the expenses (excluding prescription drugs). One might have to wait for quite some time to avail of elective procedure treatment in Spain. Non-European travelers must have valid health insurance coverage to benefit from the hospitals in Spain. One can also avail of it on a residency visa. The private insurance system helps you to avail the benefits at monthly costs. The taxes in Spain are comparatively lower than those of other European countries. Hence, one can surely opt for this country for medical treatment.
What are the conditions of the hospitals in Spain? Are they JCI certified? What is the quality of the support staff in the hospitals?
The Joint Commission International (JCI) is a global leader in health care accreditation. JCI accreditation is considered a gold standard in worldwide health care. It provides the most skilled and experienced healthcare professionals in the medical industry, as evaluators of the rigorous international standards in healthcare quality and patient safety. Here are a few JCI certified hospitals in Spain :
  • Vithas Xanit International Hospital
  • Grupo Hospitalario Quirónsalud
  • Centro Médico Quironsalud Teknon
  • Hospital General de Catalunya
  • Instituto de Microcirugía Ocular (IMO Barcelona)
  • Sanitas Hospitales
  • Guttmann Institute
  • Instituto Balear de Oftalmología (IBO)
Are the doctors/surgeons in Spain of the best quality?
The hospitals in Spain are based on “el sistema national de salud” which provides high-quality care and medical centres, that is, “centros de salud”. This system has public and private healthcare systems, often within the same level. Since many countries send ex-pats here, one can even find an English speaking doctor very easily. Most doctors are adequately skilled and can handle the cases.
What is the process for obtaining a medical visa in Spain?
One has to apply for a Schengen Visa to gain entry into Spain for a medical purpose. The required documents when applying for a Schengen Visa for Medical Treatment are as follows:
  1. Visa application form.
  2. Two photos.
  3. Valid travel document/passport.
  4. A copy of your passport's data page.
  5. Roundtrip flight reservation.
  6. Travel Medical Insurance.
  7. Proof of accommodation
What support services does MediGence provide in Spain?
MediGence has been praised on a global scale for the list of services they provide. Apart from the listed services, the staff and the guides are adorned for their customer interaction, impromptu assistance, and various other assistance related guidance throughout the tour. Thus, the list of services provided by MediGence are:
  • Insurance query related guidance
  • In-detail guidance till completion of the medical tour
  • Visa Assistance
  • Free airport to hospital transfer
  • On-Ground Support
  • Teleconsultations
  • Accommodations Assistance
  • Rehabilitation and recovery services
Which are the best cities in Spain for medical treatment?
Spain has many cities like Madrid, Barcelona, Valencia, and Pamplona that have some of the best hospitals in Spain. Madrid has good hospitals for general and reproductive health facilities. Barcelona has hospitals specializing in child healthcare.

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