Important Details Affecting the Success of Eardrum Surgery

Factors That Affecting The Success Rate of Eardrum Hole Surgery

Succes Rate of Tympanic Membrane Perforation Repair - Succes Rate of Endoscopic Myringoplasty - Factors That Affecting The Success Rate of Endoscopic Eardrum Hole Surgery - Eardrum Surgery in Istanbul

In patients with a hole in the eardrum, recurrent otitis media may occur as well as hearing loss. Minimal traumatic and transcanal techniques are used in selected patients.

The Functions of the Eardrum and the Effects of the Hole in the Eardrum on Health

Eardrum is located between the middle ear cavity and the outer tympanic membrane and the middle ear and the outer ear is a barrier area.

When a permanent puncture occurs in the eardrum, both the barrier function and the hearing-related tasks of the eardrum are affected and the following symptoms occur depending on the size and location of the hole in the membrane:
- Hearing loss
As the size of the hole in the membrane increases and the number of middle ear infections increases, the hearing loss increases. This is due to the reduction of the surface areas hit by sound waves and negative effects on the middle ear and inner ear due to infections.
- Recurrent middle ear infections
Because of the disruption of the barrier of the eardrum, the middle ear infections may develop very easily if water escapes into the external ear canal. The middle ear region has an anatomically very close relationship with the brain, neck veins and facial nerve and has serious risks such as facial paralysis, neck abscess, brain abscess, brain membrane inflammation due to recurrent middle ear infections.

In some patients with recurrent middle ear infection, foci of infection can be seen that can melt the bones called indeki cholesteatoma ın and which are trapped inside the bones in the ear region. "chronic otitis media with cholesteatoma " is an inflammatory disease of a more severe middle ear which is used for the disease of otitis media accompanied with cholesteatoma.

Succes Rate of Tympanic Membrane Perforation Repair - Succes Rate of Endoscopic Myringoplasty - Factors That Affecting The Success Rate of Endoscopic Eardrum Hole Surgery - Eardrum Surgery in Istanbul

In the above picture, an examination photograph of the patient with a large central perforation (central orifice or perforation) is seen in the eardrum. White dead epithelial tissue at the edges of the hole is seen. During the operation, all healing tissue and dead epithelial tissue at the end of this hole should be removed (disepithelization). After this procedure, the muscle membrane, cartilage or cartilage membrane can be contacted to the edges of the hole to repair the tympanic membrane.

How Is The Eardrum Surgery Performed?

The eardrum surgeries may vary depending on the size of the hole in the membrane and the presence of inflammation foci in the middle ear. In patients with a middle ear and only a hole in the eardrum, a tympanic membrane surgery (myringoplasty surgery) can be performed with a simple procedure performed only on the eardrum and tympanic membrane ossicles (tympanoplasty surgery) can be performed.

Ear Drum Repair Video

Endoscopic Repair of Eardrum Video


Small and central tympanic membrane holes can be repaired through the external ear canal without any extra skin incisions. Recently, endoscopic tympanic mebrane surgery has been performed frequently. It is frequently preferred by patients because it does not have an incision in a visible area from the external auditory canal and outer ear. It can be applied in selected patients.

People with a hole in the eardrum must protect their ears from contact with water. In patients with holes in the eardrum and not taking protective measures against water contact from the external environment, structural changes in the middle ear and ear ossicles, hardening of the joints of the ear ossicles, permanent destruction of inner ear nerve cells, and inflammatory foci around the ear ossicles adverse effects such as build-up can be seen. Therefore, the amount of surgery may be increased. For example, in a patient who can only be scheduled for performing simple eardrum surgery, such as the removal of inflammation foci in the middle ear or the addition of an ossicular bone surgery.

The success of the operation may be higher in patients who have undergone water infestation and less infection.

The size of the operation may increase in patients with a hole in the eardrum and who leakage water to ear!

People with a hole in the eardrum must protect their ears from contact with water. In patients with holes in the eardrum and not taking protective measures against water contact from the external environment, structural changes in the middle ear and ear ossicles, hardening of the joints of the ear ossicles, permanent destruction of inner ear nerve cells, and inflammatory foci around the ear ossicles adverse effects such as build-up can be seen. Therefore, the amount of surgery may be increased. For example, in a patient who can only be scheduled for performing simple eardrum surgery, such as the removal of inflammation foci in the middle ear or the addition of an ossicular bone surgery.

The success of the operation may be higher in patients who have undergone water infestation and less infection.

Smoking Affects the Success of Eardrum Surgery Negatively!

There have been many enhancing effects of smoking on upper respiratory tract infections and cancer diseases. In patients who have undergone tympanic surgery and smoke, the success of surgery may decrease with the following mechanisms:

- Negative effects of wound healing (depending on carbon monoxide, nicotine and other substances)
- Affecting the functions of the eustachian tube that ventilates the middle ear
- Nasal mucosal swelling and increased nasal congestion
- Increased frequency of upper respiratory tract infection

Patients with nasal congestion, is not suitable for the operation of tympanic membrane!

In patients with nasal obstruction, the functions of the eustachian tube, which opens the middle ear and opens to the nasal area, are adversely affected. However, it is very easy for the middle ear to be affected by pressure changes in the external environment in patients with nasal congestion. In patients with nasal obstruction and a hole in the eardrum, after the treatment of nasal congestion (medical treatment, cartilage curvature surgery, nasal surgery, polyp surgery ...), eardrum surgery should be planned.

Graft is not stitched to eardrum in eardrum repairing surgery!

Cartilage membrane, cartilage, muscle membrane can be used to repair the eardrum. After cleaning the dead tissues around the hole in the eardrum, these graft materials are placed in contact with fresh and bloody areas at the edges of the hole. In other words, the grafts are fixed to the eardrum with a clot. If the edges of the hole in the eardrum do not separate from the membrane, ie if there is a proper area of ​​contact with the membrane, cells at the edges of the hole continue to reproduce until they touch each other. In this way, the eardrum holds on the graft and renews itself.
What happens if these graft materials are separated from the eardrum? The eardrum cells in those regions will die again, and the holes left in the graft will most likely remain in the area.

The following movements and conditions should be avoided following the tympanic surgery:

- Sneeze with closed mouth
- Constipation and straining
- Ear injury
- Air travel in the early period after surgery
- To miss the water contact of ear

Eardrum Surgery in the Presence of Middle Ear Active Infection Success Chance is Low!

Care is taken not to have active infection in the middle ear in the eardrum operations. This can be explained by the presence of infection residues between the graft and membrane placed on the eardrum, disruption of the healing of the eardrum, or inflammation of the eardrum.

In patients with middle ear inflammation and in which membrane surgery is planned, it is important to evaluate the pre-operative otitis media and to regulate the appropriate medical treatment. In patients who do not improve the inflammation despite appropriate medical treatment, it is necessary to evaluate the latent inflammation foci trapped within the ear bones and to determine the mode of surgery accordingly.

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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
E-Mail: muratenoz@gmail.com
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47


  

 


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