People from all age groups can be affected by ear disorders and hearing impairment problems. In the United States, a survey revealed that under the age of 65, over 60 percent of the population suffers from problems related to hearing loss. However, almost 25 percent 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
Several reasons 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.
The process will include an audiogram and history of the loss of hearing. It shall also evaluate facial weakness or vertigo experienced.
A microscopic examination is performed and otoscopy is used to understand the mobility of the malleus and tympanic membrane. A fistula test is also performed if a history of marginal perforation and dizziness is found. Apart from this entire blood and urine test is conducted prior to surgery.
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.
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