Surgical intervention: tympanoplasty. Feedback after surgery

Hearing problems can occur for various reasons, and in some cases the essence of the disease is reduced to a worsening of the functions of the middle ear. In order to restore it, we use tympanoplasty, an operation during which the tympanic membrane itself is reconstructed . This form of treatment has repeatedly proved its effectiveness.

The essence of the problem

When it comes to a form of surgical intervention, such as tympanoplasty (surgery on the middle ear), we mean a specific technique for treating chronic purulent otitis in the region of the tympanic membrane. It is important to note that such an impact is complex in nature and has a significant restorative effect, allowing the reconstruction of the middle ear.

It makes sense to pay attention to the fact that chronic otitis is diagnosed often enough. It leads to the formation of a hole in the tympanic membrane, which is called perforation. For this reason, the penetration of pathogenic bacteria into the tympanic cavity becomes possible, which in turn leads to the release of pus, which can bother more than one year.

Timpanoplasty is an operation without which it is extremely difficult to overcome purulent otitis media. In addition, a neglected disease of this type can result in the onset of abscess and thrombosis of cerebral vessels, and in some cases - with meningitis.

Indications for operation

There are a number of conditions under which the aforementioned surgical intervention is necessary. The essence is about the following health problems:

- the formation of the marginal or central perforation of the tympanic membrane, which causes the displacement of the auditory ossicles;

- polyps, developing in the middle ear;

- tympanosclerosis;

- Perforation of the tympanic membrane, not accompanied by inflammatory processes;

- fibrosis of the middle ear.

Obviously, there are many reasons why surgical intervention can be relevant.

Contraindications

It is important to understand that there are cases when an operation on the ear (tympanoplasty) will not be able to exert the desired influence. Here are the diagnoses, in which it is absolutely not recommended to use such a technique:

- exacerbation of chronic diseases;

- adhesive otitis media;

- complete deafness;

- severe general condition of the patient;

- sepsis and purulent complications.

Sanitarian surgery on the middle ear with tympanoplasty is contraindicated also in the case when a persistent impairment of the patency of the auditory tube is fixed. This category includes congenital anomalies, as well as scars, as well as spikes, resulting from inflammation.

Contraindications of a relative nature

In this case, we are talking about those diseases, against which the operation is undesirable, but possible. In this case, the final decision will be made by the doctor, based on his experience and the condition of the individual patient. So, the contraindications themselves:

- acute inflammation in the middle ear;

- diseases of the allergic type in the stage of exacerbation;

- problems with upper respiratory tract;

- the process of epidermisation.

Only taking into account all the contraindications described above, one can prescribe this type of treatment, such as tympanoplasty. Feedback after surgery is an important sign of the quality of treatment, so always be interested in the opinions of patients about a particular clinic. Forums can help in this.

It is worth remembering that the doctor is obliged to conduct a survey of another ear and make predictions about the risk of his defeat. After this, a decision will be made regarding the operation on the second eardrum.

A full-scale general examination should also be conducted: coagulation, biochemical and general blood and urine tests, and blood tests for syphilis, HIV, hepatitis B and C. The ECG is included in the examination program.

The process of preparation for surgical treatment

Before the surgery, perform a conservative treatment, which is designed to prepare the ear for tympanoplasty. In the cavity of the middle part, where the tympanic membrane is located, various drugs are introduced, designed to have an anti-inflammatory, vasoconstrictive and antibacterial effect. All of them have a wide range of activities.

Such procedures are very important, since they make it possible to clean the operated zone from infection. It is thanks to this procedure that safe tympanoplasty becomes possible. Feedback after surgery, respectively, will also be mostly positive, since sanitation (purification) initially blocks the effect of infection on the middle ear, and subsequently promotes rapid healing of the postoperative wound.

Moreover, such a measure leads to improved patency of the auditory tube, which has the most direct impact on the quality of the result of surgical intervention.

If a patient has chronic illnesses, then it is necessary to get a consultation from a specialized doctor. 7 days before the operation is performed, you need to refuse to accept funds used for dilution of blood. These are non-steroidal anti-inflammatory drugs (Paracetamol, Aspirin) and Warfarin.

Types of impact

There are various techniques that allow a significant improvement in the condition of the middle ear after surgery. For this reason, tympanoplasty can also be carried out in different ways. It makes sense to distinguish three key areas:

- Restoration using ossiculoplasty . Actual for those patients who, due to a serious inflammatory process, the auditory ossicles were damaged, and their rehabilitation is possible only with the help of prosthetics. In this case, materials such as titanium, cement and plastic are used.

- The essence of the second type is reduced to closing the tympanic membrane by means of the own tissues of the middle ear . The most common and least difficult is precisely this tympanoplasty. Reviews after surgery of this type are overwhelmingly positive.

- Meningoplasty without prosthetics. It is used to treat patients with damaged auditory ossicles, but prostheses are not used. To restore enough native bone tissue.

Sometimes doctors are faced with such a problem as the fusion of the two surfaces of the middle ear, which is caused by a complication after otitis media. In this case, for the restoration of the tympanic cavity, both grafts and the eardrum itself, or more precisely, its remains, are used.

Rehabilitation period

In order that, with the use of such a method of treatment as tympanoplasty, the feedback after the operation was positive, it is necessary to organize a qualitative recovery of the patient.

First of all, this stay for 1-3 days in a hospital. Rehabilitation includes the use of antibiotics throughout the first postoperative week. Along with these restorative measures, the daily carrying out of anemia is topical. This means the introduction of vasoconstrictive drugs into the pharyngeal mouth of the auditory tube.

Since the release of the ear canal from tampons occurs gradually, at first the patient must on a regular basis come to inspections.

To get back to normal as soon as possible after surgery, you need to sneeze less, blow your nose and protect the auricle from getting water into it. As for effective methods of protection against moisture during showering, it is better to consult with your doctor. From lifting heavy items also have to give up. In fact, it is necessary to exclude any loads that can cause a strong tension in the middle ear area.

Possible complications

If we consider all facets of surgical intervention, it is worth noting that there are certain risks during the procedure such as tympanoplasty. Complications after surgery can be completely different: damage to the labyrinth, tympanum, facial nerve and even hard meninges. The latter, by the way, sometimes causes bleeding from the jugular vein or otlikvorei.

Also worth paying attention to the risk of aseptic inflammation of the ear in the postoperative period. This condition, as a rule, is accompanied by secretions, edema and pain sensations.

Occasionally, after the operation of tympanoplasty, gnotism may appear in the ear. The feedback is confirmed by the fact that a similar problem exists. For this reason, the stationary regime is important during recovery, because with possible complications doctors will be able to provide qualified and timely assistance.

The complications of a general nature include long-term headache (the effects of the labyrinth fistula), imbalance and dizziness.

How are things with transplants

Those who underwent surgery with the use of prosthetics should follow the recommendations of doctors exactly, since in the case of inflammation of the middle ear, the process of rejection may begin.

The fact of inflammation will also affect the rate of recovery. After using tympanoplasty with the use of prostheses, there is a risk of displacement of the latter, as well as necrosis or atrophy. So, if there was a prosthetic repair, you need to take care of yourself thoroughly.

Hearing loss

The group of complications includes the manifestation of deafness in the operated ear, which can reach the level of complete deafness. This problem makes itself felt after a complicated or non-radical tympanoplasty. Violation of the perception of sound is sometimes the result of a reactive labyrinthitis, which can pass without medical procedures. If this does not happen, competent therapy under the supervision of a doctor will help neutralize this problem.

Thus, it is necessary to understand that the hearing impairments caused by the labyrinthitis, the character is temporary and amenable to treatment.

But the good news is that such complications are observed only in 3% of patients who underwent surgery. Tympanoplasty reviews Has mostly positive, so you should not be afraid of this technique.

Short-term paralysis

This is another complication that may occur after surgery in the middle ear. The good news is that the nature of this problem is temporary. The cause of short-term paralysis is postoperative edema of the facial nerve.

In some cases, this nerve can be damaged due to intraoperative crossing. As a restorative measure, plastic is used. It's about sewing the subcutaneous nerve of the neck. Alternatively, the facial nerve is sewn with the sublingual. At a similar intersection during surgery, even after plastic surgery, there remains the risk of retaining residual muscle weakness in the face.

Reviews

If you study the comments of people who decided to reconstruct the middle ear, then we can conclude that this method of treatment is very effective.

The majority advises to decide on such measures for chronic otitis, because in their case the problem was solved only after the operation "tympanoplasty." When there is complete recovery, one can not say for sure in view of possible complications and peculiarities of the organism of each particular patient.

But if we talk about the average indicators, then the ear comes back to normal after a month from the date of the operation.

Results

Chronic otitis is a serious enough disease, and if it is started, the damage to the middle ear can be significant. Timpanoplasty, in turn, allows to completely neutralize this problem and restore the tympanic membrane. In addition, the operation itself lasts about an hour. Therefore, there is no reason to ignore such treatment.