Tympanoplasty (Eardrum Repair)

The ear, one of our most important organs for communicating with the outside world, consists of three parts: outer, middle, and inner. The Eardrum (Tympanic Membrane), which separates the outer ear canal from the middle ear, functions not only to vibrate sound waves and transmit them to the inner ear but also acts as a barrier protecting the middle ear against external microbes.

A perforated eardrum due to infections, trauma, or pressure changes leads to both hearing loss and chronic ear discharge.

The Tympanoplasty surgery performed by Op. Dr. Bekir Can Gümüşlü is the process of repairing this perforation and correcting any damage to the middle ear ossicles (tiny bones), if present.

Why Does the Eardrum Perforate and What Are the Symptoms?

Eardrum perforation generally occurs due to the following reasons:

• Frequent and untreated middle ear infections.

• Severe blows to the ear (slapping, ball impact).

• Damaging the membrane with cotton swabs or foreign objects.

• Exposure to very loud noises (explosions).

A perforated eardrum causes the middle ear to become inflamed when water enters from the outside, leading to foul-smelling discharge. Over time, this infection can erode the ossicles, resulting in permanent hearing loss. Furthermore, it can turn into a dangerous type of inflammation called “Cholesteatoma,” which progresses by eroding the bone.

Types and Techniques of Tympanoplasty Surgery

Before a surgical decision is made, an Audiometry (Hearing Test) and, if necessary, a Tomography scan are performed on the patient. Different techniques are applied based on the size of the perforation and the degree of hearing loss:

• Type 1 Tympanoplasty (Myringoplasty): There is no damage to the ossicles; only the membrane is perforated. The membrane is repaired.

• Combined Tympanoplasty: Along with the repair of the membrane, the ossicular chain (malleus, incus, stapes) that provides sound transmission is repaired using prosthetics or the patient’s own bones.

• Mastoidectomy: If the infection has spread to the mastoid bone (the honeycomb-like bone structure) behind the ear, the inflammation in this area must be cleared.

Op. Dr. Bekir Can Gümüşlü utilizes Endoscopic or Microscopic methods in surgery.

Graft Material: To repair the membrane, the patient’s own tissues are used rather than synthetic substances. Generally, the muscle sheath (fascia) behind the ear or cartilage taken from the earlobe (tragus) is used as a graft. These tissues carry no risk of rejection by the body, and the success rate is very high.

Incision: Depending on the location of the perforation, the surgery can be performed through the ear canal (without an incision) or via a small incision made behind the ear.

Recovery Process and Water Protection

After Tympanoplasty, our patients are generally discharged on the same day or the following day.

• Pain: Post-operative pain is very mild.

• Packing: Dissolvable sponges are placed inside the ear; therefore, suture removal or packing removal is usually not required.

• Water Protection: This is the most critical point of the recovery process. The patient must not allow water to enter the operated ear for at least 1–2 months. While showering, cotton with Vaseline or special earplugs should be used.

Result: Once the graft takes (the success rate is over 90%), the patient is freed from the risk of chronic infection and achieves a significant increase in hearing levels. Swimming in the sea or pool is no longer just a dream.