Tympanoplasty in Thailand

Treatment and Cost

10

Total Days
In Country

2 No. Travelers

2 Day in Hospital

8 Days Outside Hospital

Treatment cost starts from

USD 2200

Hospitals

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 Thailand / Why should opt for Thailand as a destination for your medical treatment
Hospitals in Thailand have seen an increase in number in the past few years. One of the many reasons for such surprise growth in the healthcare division can be the development of the public health sector which comprises 9,765 health locations along with 1,002 hospitals. As the Public Hospitals in Thailand are operated by the MOPH (Ministry of Public Health), the Private Hospitals in Thailand are regulated under the Medical Registration Division. The treatments in Thailand are also keeping up with that of other major countries all across the globe. As of 2002, the Thai Government has provided a countrywide general healthcare system that covers 99.5% of the Thai population and ensures high-quality treatments in Thailand and affordable primary medical amenities to each and every citizen of Thailand. In the year 2009, the total national expenditure on healthcare was 4.3% of the GDP of Thailand. Due to such medical advancements in Thailand, the country has become the most preferred medical destination in the world providing wide-ranging medical treatments at highly-reasonable rates at good hospitals in Thailand.
What are the conditions of the hospitals in Thailand? 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 Thailand :
  • Yanhee Hospital
  • Bumrungrad Hospital
  • Bangkok Hospital
  • Chaophya Hospital
  • BNH Hospital
  • Ramkhamhaeng Hospital
  • Vejthani Hospital
  • Bangkok Hospital Phuket
  • Samitivej Sukhumvit Hospital
  • Praram 9 Hospital
  • Chiangmai Ram Hospital
  • Sikarin Hospital
  • Synphaet Hospital
  • Bangkok Hospital Samui
  • Nonthavej Hospital
  • Bangkok Hospital Pattaya
  • Samitivej Srinakarin Hospital
  • Samitivej Sriracha Hospital
Are the doctors/surgeons in Thailand of the best quality?
Thailand is gaining recognition for the quality of its healthcare services after the US magazine CEOWORLD placed Thailand 6th in its 2019 list of countries with the best healthcare systems. Thai doctors gain a lot of skills during their course and this helps them practice effectively. Many doctors and surgeons also visit other countries for training and certification courses to enhance their skills and knowledge. Most doctors are exposed to a public and private healthcare system in order to be able to work in any condition. It is a collective effort from all the professionals to maintain the standard of health and Thailand is doing just that.
What is the process for obtaining a medical visa in Thailand?
Currently, medical tourists To Thailand are allowed in from 34 countries. All visitors must have proof of travel health insurance that covers a minimum of US$100,000 of medical costs incurred in Thailand, including medical costs in the event that they contract COVID-19. Under the CCSA regulations, medical tourists have to arrive by air to ensure effective disease control, not via land border checkpoints. All must have an appointment letter from a doctor in Thailand and entry certificates issued by Thai embassies across the globe. People wanting to visit Thailand for medical procedures need to contact the Thai Embassy in their country to organize the visa and paperwork. Thailand’s major hospitals will provide potential candidates with an appointment letter. Permission for medical tourists to be accompanied by up to three attending persons is intended to allow such patients to have spouses, parents, or assistants in attendance during their treatment in Thailand. However, such persons will have to conform to all the same entry requirements as the medical tourists themselves, including visas and health status.
What support services does MediGence provide in Thailand?
MediGence enables you to plan and manage your medical decisions better. These are some of our services offered:
  • Expert Opinion
    We help you seek an Expert Opinion on your diagnosis and treatment from an experienced team of doctors at MediGence and specialists from a reputable hospital.
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    We recommend a hospital or a healthcare institution that is best suited for you, based on your ailment and its criticality.
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  • Doctor Validation and Communication
    We share a comprehensive profile of the treating doctor and also arrange a call to clear queries regarding treatment if needed.
  • Options to Choose From
    Based on your choice of destination and other preferences, we provide you multiple options with respect to hospitals and doctors to choose from.
  • 24X7 Patient Care Support
    A dedicated patient case manager stays in constant touch with you to help you at every step of the decision-making process and resolve queries that you may have.
  • Transparent Treatment Cost and Other Expenses
    We give a clear and accurate indication of the total cost of treatment including treatment, stay, meals, and other expenses.
  • Visa Assistance
    We provide and help prepare documentation for visa approval and coordinate with the embassy to expedite the visa process.
  • Accommodation Arrangements
    We propose to you a choice of accommodation based on your preference such as long stay, short stay, or luxury properties.
Which are the best cities in Thailand for medical treatment?
Bangkok is the capital of Thailand and the most sought - after destination for healthcare. It has more than 10 of the major hospitals in Thailand. The cost of treatment in Thailand is reasonable here. People tend to spend their recovery time in Bangkok as well as it is a beautiful city to visit as a tourist.

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