Tympanoplasty – Purpose, Procedure And Surgical Instruments

 

The ear is an important organ that allows us to hear sounds and maintain balance. Any injury to our ear can cause us major discomfort and pain. Ear diseases can lead to hearing loss, balance disorders, and tinnitus. There are many surgical procedures to solve ear-related medical issues. Healthcare professionals use specifically designed surgical instruments to perform different tasks during the surgery. As ears are relatively smaller organs of our body, most of the instruments used in this surgery are designed for microsurgical procedures. They have fine and sharp tips that perform the task with high precision and accuracy. There are several surgical procedures that can be done to improve the situation, such as ossiculoplasty, mastoidectomy, tympanoplasty, etc. Let us discuss tympanoplasty in detail.

Tympanoplasty

Purpose:

Tympanoplasty is done to patch a hole in the eardrum that is not healing by itself. It can be caused by ear infections, accidents, injury, or some previously done ear surgery. In order to reach the surgical site, the surgeon either goes through the ear canal or makes an incision behind the ear. Through this invasive procedure, the tympanic membrane, eardrum, or middle ear bone is repaired.

Procedure:

Tympanoplasty involves a lengthy surgical procedure. The following steps describe the procedure in detail along with the commonly used surgical instruments:

• Step 1: Preparation

The first thing to do is to prepare the ear for the surgery. The ear is draped for this purpose. In order to numb the area and save the patient from extreme pain, the surgeon injects the ear with xylocaine along with epinephrine through a syringe.

• Step 2: Reaching the Site

There are two approaches that can be adopted for this procedure.

• Post Auricular Approach

In this approach, the surgeon makes an incision at the back of the ear to reach the surgical site. To access the ear canal skin, a periosteal elevator is used to reflect the periosteum over the anterior mastoid tip. Gentle traction is used to elevate the ear canal skin. This allows the surgeon to enter the ear canal. Gelpi Retractor is used to hold the incision open.

• End Aural Approach

In this approach, the surgical site is accessed directly through the ear canal. However, a small incision is still needed to harvest the fascia in order to repair the eardrum. The ear canal is widened using ear speculums.

• Step 3: Closing the Perforated Eardrum

At this stage, the harvesting of a piece of fascia is done using ear scissors in order to patch the hole in the eardrum. The harvested fascia is dried and pressed to make the placement easier.

• Step 4: Rim the Perforation

The margins are freshened up using forceps or needles at this step.

• Step 5: Ear Canal Flap Elevation/Cutting

The ear canal is elevated using an ear knife. Some surgeons use a beaver blade to cut the ear canal skin flap. However, that can cause excessive bleeding.

• Step 6: Remove Blood

Baron Suction is used to remove the blood and cerumen to clean the area.

• Step 7: Ear Canal Flap down

The ear canal flap can now be elevated down to the eardrum. This step can be hard to do.

• Step 8: Placing the Temporalis

At this stage, alligator forceps are used to place the temporalis in the middle ear. After that, the fascia is pushed forward.

• Step 9: Gel Foam Placement

This is the final step. After placing the fascia, gel foam is inserted between the fascia and the middle ear mucosa. It keeps it in place.

Potential Risks:

This surgery, even though complicated, is the ideal way to help a perforated eardrum heal perfectly. The use of a fascia to fill the hole is indeed a remarkable way to help the patient. However, just like any other surgery, there are some risks. Tympanoplasty can cause you to have dizziness afterward. There is a risk of infection and excessive bleeding. There is a chance that the graft may not survive. The hearing may get worse or stay the same. The patient can also experience ringing in the ear and strange taste.

Guidelines for Patients:

The patients must always follow the surgeon’s advice. They should tell the practitioner about the medications they are currently taking or the food they ate before the surgery. This surgery is invasive in nature, and lying to the surgeon can lead to fatal consequences.

Do you want to buy the surgical instruments mentioned above? Contact Us

GerMedUSA Inc. presents a wide range of high-quality German stainless surgical instruments. You can get the ones discussed above to perform tympanoplasty with exceptional skills and success. We have the ones with tungsten carbide inserts, supercut design, color-coating, and titanium. We have all kinds of specially designed surgical instruments for surgeons with high standards.

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