Tympanoplasty in Turkey

Treatment and Cost

10

Total Days
In Country

2 No. Travelers

2 Day in Hospital

8 Days Outside Hospital

Treatment cost starts from

USD 4500

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 Turkey / Why should opt for Turkey as a destination for your medical treatment?
The healthcare infrastructure of Turkey comprises health centers, health posts, mother and child health and family planning centers, tuberculosis dispensaries, etc. Health centers are each staffed by a team consisting of a doctor, a nurse, a midwife, a health technician, and an administrator. Health posts report to health centers and are each staffed by a midwife. Health centers and health posts are the only settings providing preventive care, health promotion, and community-based health services. All other settings use specialists to provide just primary diagnostic and curative care. Turkey is turning out to be a preferred destination for medical treatment by many people across the world for its pace of development. The people are friendly and the administration is efficient. After the treatment in Turkey, one can even choose to unwind amidst its beauty.
What are the conditions of the hospitals in Turkey? 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 Turkey :
  • Anadolu Medical Center
  • Hisar Intercontinental Hospital
  • Medipol Mega University Hospital
  • NP Istanbul Brain Hospital
  • Neolife Oncology Center
  • Liv Hospital
  • Medicana Healthcare Group
  • Kadikoy Florence Nightingale Hospital
  • Istanbul Memorial Hospital
  • Memorial Antalya Hospital
  • Taksim Hospital
  • Dunyagoz Hospitals Group, Istanbul, Turkey
  • Medical Park Hospitals Group
  • Medical Park Göztepe Hospital Complex
  • Acibadem Maslak Hospital
  • German Hospital Taksim
  • Medical Park Bahçelievler Hospital
  • Göktürk Florence Nightingale Medical Center
  • International Hospital
  • Aydinlar Dental Group
Are the doctors/surgeons in Turkey of the best quality?
Doctors in Turkey are highly educated and well trained. This is one of the reasons why many people flock to Turkey for medical treatment. The doctors are skilled and can converse fluently in English and other foreign languages.
What is the process for obtaining a medical visa in Turkey?
At present, there are two types of medical visas available for your visit to Turkey:
  1. Medical Visa, which can be obtained from the Consulate of Turkey
  2. Online Visa (eVisa), which can be obtained in advance of arrival via the government of Turkey’s online visa system.
Visitors must obtain a medical visa for traveling to Turkey unless they come from visa-exempt countries and territories or citizens of those countries, which are eligible to apply for an e-Visa online. How To Acquire Online Medical Visas (e-Visa or electronic visa) :
  1. Simply visit www.evisa.gov.tr and apply on the platform by selecting your country and the type of passport or identity card. The platform is self-explanatory and will guide you throughout every step.
  2. Once you are done filling the form, save and download the form for future references.
  3. The applicant must visit the nearby Turkish embassy in his/her country to get the approval of the Consulate.
  4. Once the visa is approved, the travel dates can be scheduled accordingly.
What support services does MediGence provide in Turkey?
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 Turkey for medical treatment?
The capital of Turkey is Istanbul. Istanbul is easily accessible and the preferred location for medical treatment. Other cities with good hospitals are Izmit and Bursa.

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