Myringoplasty Operation in Istanbul, Turkey
Myringoplasty Operation
Myringoplasty, the eardrum surgery is the name given to the closure of small holes in eadrum. For this purpose, faty tissue, paper, muscle membrane (fascia), cartilage and cartilage membrane (perichondrium) can be used. When myringoplasty is combined with ossicular reconstruction, it is called tympanoplasty. You can see my last detailed article about this subject at >> Ear Drum Repair (Tympanoplasty / Myringoplasty) in Istanbul
The aim of the eardrum surgeries (tympanoplasty / myringoplasty):
- Prevent recurrent ear infections.
- Improve hearing, if there is a conductive hearing loss due to eardrum perforation.
- Enable patients to swim or get ear wet without facing infection as a consequence.
Tympanic Membran Perforation - A Hole In The Eardrum
Tympanic membrane perforation defined as hole or tear in ear drum. This problem can cause to hearing loss and deterioration of barrier function of ear drum.
Perforations without infection or cholesteatoma are not painful. The patient may report audible whistling sounds during sneezing and nose blowing, decreased hearing, and a tendency to infection during colds and when water enters the ear canal. Perforation with infection typically results in copious purulent drainage, which may be sanguineous in both acute and chronic perforation. Surgeries to treat the eardrum (tympanoplasty or myringoplasty) can made according to perforation dimension and middle ear state.
Myringoplasty Technique
Eardrum Repair Animation
Myringoplasty techniques include the paper-patch method, fat-plug myringoplasty, a gelfoam plug in combination with surgical removal of the perforation edges, and fibrin glue or a patch composed of a hyaluronic acid ester and a dressing component.
We can perform transcanal (transmeatal, endomeatal) myringoplasty (without endaural incision or retroauricular incision and operation perform via the external auditory canal). With this techinique recovery time is shor and postoperative patient complaints less in comparison to other techniques.
Quality microscope and surgical experience required for the implementation of this technique.
Myringoplasty is often done under general anaesthesia, but it can be done under local anaesthesia also.
Myringoplasty is often done under general anaesthesia, but it can be done under local anaesthesia also.
Endoscopic Transcanal Myringoplasty
In the video above, you can watch the operation of closing the eardrum bee hole through the external ear canal with the help of the endoscopic system, without making any additional incisions. The cartilage and cartilage membrane used here were removed by making a 1 cm incision from the patient's ear region called the tragus, an area that cannot be seen from the outside. Many patients prefer this method because it is a minimally traumatic surgery, since there is no visible incision. I would like to emphasize here that; we can only perform endoscopic eardrum repair surgery in suitable patients.
Microscopic Transcanal Myringoplasty
Above, you can watch the video of myringoplasty operation performed inside the external auditory canal with the aid of a microscope. What was done in the video:
- the earwax in the external ear canal is removed - aspirated
- circular removal of white and dead epithelial tissue in the eardrum hole
- fresh bleeding areas are visible on the edges of the membrane hole
- fibrotic bands in the middle ear and surrounding the ossicles are removed
- pieces of sponge and small cartilages are placed in the middle ear for support purposes
- graft obtained from tragal cartilage and "prepared as an island graft" is being rehearsed
- the graft is placed overlay with the perichondrium outside and the cartilage inside
- all perforation edges are checked and additionally dried perichondrium is laid
- bleeding control is done
- after all the perforation is seen to be closed, pieces of sponge gel impregnated with antibiotic eye ointment and compressed are laid on the grafts
- a earpack is placed in the external ear canal, the operation is terminated by bandaging.
In this video that I shared with you here, no visible incision was made outside the patient's ear. According to the endoscopic technique, the surgeon has the opportunity to use both hands at the same time in the microscopic transcanal myringoplasty operation.
Perforated Eardrum Repairing Surgery (Endoscopic Transcanal Myringoplasty) Video
Myringoplasty Indications
Myringoplasty operation should be sutable in the following cases:
- Small, central and dry ear drum perforation
- Dry tympanic mebrane perforations (either central or marginal)
Myringoplasty Contraindications
Myringoplasty operation should not be performed in the following cases:
- Active discharge from the middle ear
- Middle ear cholesteatoma which can cause spontaneous drainage from the ear
- Uncontrolled nasal allergy
- When the other ear is dead (deaf ear)
- Patients with less than 3 years of age
Postoperative Patient Care For Myringoplasty Operation
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| Postoperative Patient Care For Myringoplasty Operation |
- Do not blow your nose until your physician has indicated that your ear is healed. Any accumulated secretions in the nose may be drawn back into the throat and expectorated if desired. This is particularly important if you develop a cold.
- Do not “pop” your ears by holding your nose and blowing air through the eustachian tube into the ear. If it is necessary to sneeze, do so with your mouth open.
- Do not allow water to enter the ear until advised by your physician that the ear is healed. Until such time, when showering or washing your hair, lamb’s wool or cotton may be placed in the outer ear opening and covered with Vaseline.
- If an incision was made in the skin behind your ear, water should be kept away from this area for 1 week.
- Do not take an unnecessary chance of catching cold. Avoid undue exposure or fatigue. Should you catch a cold, treat it in your usual way, reporting to your doctor.
- For avoiding constipation to eat foods of high in fiber and walking may be useful.
- Do not “pop” your ears by holding your nose and blowing air through the eustachian tube into the ear. If it is necessary to sneeze, do so with your mouth open.
- Do not allow water to enter the ear until advised by your physician that the ear is healed. Until such time, when showering or washing your hair, lamb’s wool or cotton may be placed in the outer ear opening and covered with Vaseline.
- If an incision was made in the skin behind your ear, water should be kept away from this area for 1 week.
- Do not take an unnecessary chance of catching cold. Avoid undue exposure or fatigue. Should you catch a cold, treat it in your usual way, reporting to your doctor.
- For avoiding constipation to eat foods of high in fiber and walking may be useful.
Myringoplasty Operation Fee
The cost of the myringoplasty operation varies between 3000 - 4500 US Dollars, depending on the hospital where the operation is performed and the materials used. Since it is an operation that is usually performed with the help of endoscopic and microscopic techniques; The operating conditions in the hospital are very important.
Is it Possible to Flight After Myringoplasty Operation?
After all eardrum operations, patients should be very careful while traveling by plane. It is appropriate to avoid air travel, which may cause pressure trauma, if possible, especially in the early period immediately after the operation. After the myringoplasty surgery, the tampons in the external ear canal can usually be removed 1-2 weeks later. Afterwards, we recommend our patients to travel by plane by paying attention to the following recommendations:
- squeezing decongestant sprays into the nose and relaxing the intranasal airway before the flight
- initiation of appropriate medical therapy to relieve nasal congestion if signs of upper respiratory tract infection or allergic rhinitis are present
- After the aircraft descent announcement, it is appropriate to regularly swallow and drink a little water.
Despite all these suggestions; Patients with severe nasal congestion should seek the opinion of their doctor before the flight.
Exercise, Swimming and Sports Activity After Myringoplasty
After all eardrum surgeries, it is ideal not to do sports activities that may cause trauma in the head area or cause sudden pressure increase in the middle ear for at least 1 month. However, walking, jogging, light lifting in sitting position can be done from the 1st week after the operation. It is necessary to be very careful about swimming in the pool and sea. Despite the swim plug, external ear canal cushion and similar materials that tightly close the external ear canal, despite the tight swim cap; Swimming underwater is inconvenient for at least 6 periods after myringoplasty. There is a risk of both pressure change and water leakage into the ear. Even under a few meters of water, contact with tons of water can cause adverse changes in the surgical field.
Source links:
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
Appointment Phone: +90 212 561 00 52
Fax: +90 212 542 74 47
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