Tympanoplasty surgery complications

Tympanoplasty surgery complications

How long does it take to heal after a tympanoplasty?

What can you not do after tympanoplasty?

What is the success rate of tympanoplasty?

What are the risks of ear surgery?

 

Tympanoplasty surgery complications

 Pain, infection and bleeding are complications of any surgical procedure. These are fortunately rare in ear surgery. Blood loss after tympanoplasty surgery is usually too small to measure. The ear is numbed with long lasting drugs that generally keep the patient comfortable for many hours. Most patients use Tylenol or Motrin/Advil for pain. Narcotics are occasionally used. Infection after ear surgery is very rare. Antibiotics are used for 1 week after medial and lateral tympanoplasty.

The most common complication is failure of the hole to heal. The frequency of this depends on its size, location, health of the ear and procedure chosen. It can occur in up to 8% of difficult cases. Most patients can then go on to have revision surgery which is usually successful. A second complication is hearing loss. Most patients enjoy improvement of their hearing after successful tympanoplasty but scar tissue formation, Eustachian tube problems and problems with the bones in the middle ear can result in on-going hearing loss. The hearing can rarely be worse after surgery. Conductive, sensorineural or mixed hearing loss may occur. Tinnitus, or ringing in the ear can occur if the hearing worsens.

Taste change can occur after ear surgery due to a nerve of taste that runs under the eardrum and brings taste to the side of the tongue. Loss of taste on the side of the tongue can occur in up to 10% of ear procedures and last for a few months. It can rarely be permanent and is more of a problem in patients who have had surgery in their other ear.

Vertigo and dizziness is common after ear surgery but is usually short-lived and rarely persists. Many medications are given during surgery to prevent nausea and vomiting.

Facial nerve paralysis is a very rare complication of ear surgery. The facial nerve travels through the ear and can rarely be injured during surgery. A facial nerve monitor is used during medial and lateral tympanoplasty which delivers an EMG of the facial nerve to prevent injury.

 

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How long does it take to heal after a tympanoplasty?

If a tympanoplasty surgery was done, your child will not be able to hear normally in the operated ear until the packing behind the eardrum dissolves. Full tympanoplasty surgery recovery time can be 2 to 3 months. In fact, the hearing will probably be worse than it was before surgery until this packing dissolves.

At the first postoperative visit, your doctor may gently clean the ear canal with a vacuum in order to inspect the reconstructed eardrum. You may be asked to use some antibiotic ear drops for a week or two to treat any postoperative inflammation.

 

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What can you not do after tympanoplasty?

While you are healing, it is important to avoid getting water in your ear. You will also need to avoid heavy lifting, strenuous exercise, and other activities that may put pressure on your eardrum. This includes flying in an airplane, swimming, scuba diving, or playing contact sports.

 

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What is the success rate of tympanoplasty?

Tympanoplasty is an effective procedure that can lead to improvement in hearing function in patients and prevention of recurrent ear discharge. A study conducted on 389 revision tympanoplasty cases showed the grafting success rate of 90%.

 

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What are the risks of ear surgery?

It is not possible to list every complication that may occur before, during, and following a surgical procedure. The following discussion is included to indicate some of the risks and complications related to most ear surgeries. Consult your physician for those more common with your particular condition and procedure. However, all these operations are major and may have significant complications.

  • Hearing Loss

Occasionally a loss of hearing can occur: however, in the vast majority of cases hearing is the same and sometimes better. Often, total hearing loss will be indicated by your physician prior to surgery (this may vary depending on your specific operation). Fortunately, the development of hearing aids and devices, has allowed the transfer of sound from the operated ear to the other ear, so that one may hear for social or business purposes from the operated side.

  • Ear Noises

Ear noise (tinnitus) usually remains the same after surgery as it did before surgery. In approximately 30% of patients the tinnitus may be less, but in 10% it may be more noticeable.

  • Taste Disturbance and Mouth Dryness

In approximately 5% of the patients, this disturbance may be prolonged. But in most it lasts for a few weeks and then disappears.

  • Dizziness and Balance Disturbance

In many of these patients, there is an improvement from the preoperative unsteadiness after surgery. Nevertheless, in most patients there is some temporary dizziness following surgery, which may be severe for days to a few weeks. Imbalance or unsteadiness on head motion is prolonged in 30% of the patients. Some patients notice unsteadiness when fatigued for several years. There are programs to enable the patient to overcome the dizziness and imbalance. In a few cases, the blood supply to the portion of the brain responsible for coordination (the cerebellum or brainstem) is decreased by the tumor or removal of the tumor. Difficulty in coordination and balance may, therefore, last in these patients for years.

  • Facial Paralysis

This nerve controls the movement of the muscles to the face, including those that close the eye. It is very common to have a temporary paralysis of the muscles of the face following some procedures. This weakness may persist for six to twelve months and occasionally, there may be permanent residual weakness or paralysis.

A facial paralysis may result from nerve swelling, or nerve damage. If it is merely nerve swelling, it may return in a short time (three weeks to three months). Swelling of the nerve is common due to the fact that the nerve is compressed and distorted by the tumor in the internal auditory canal. Tumor removal with the use of the operating microscope, facial nerve monitor, and electrified instruments usually results in preservation of the nerve, but nerve stretching may result in swelling of the nerve, with subsequent temporary paralysis. Facial function is observed for approximately one year following surgery. If it becomes certain the facial function will not recover (approximately 15% of the cases), a second operation may be performed to connect the facial nerve to a nerve in the neck (facial-hypoglossal anastomosis).

  • Eye Complications

The major medical problem with facial paralysis following this surgery is that the eye may become dry and unprotected. It can then become infected or abraded. Care by an eye specialist (ophthalmologist) may be necessary. It may be necessary to use ophthalmic (eye) drops, or apply ointment to the eye frequently, insert a gold weight beneath skin in the upper eye lid to close the eye lids, or even to partially sew the eyelids closed. The purpose of these efforts is to keep the eye moistened, as well as provide comfort, and improve the appearance.

  • Complications and Death

Usually careful dissection and attention to details under the microscope will avoid complications. However, the blood supply to the vital brain centers may be disturbed in the removal of the tumor and some other procedure. If this occurs, serious complications result, including loss of muscle control, stroke, paralysis, or death. In our experience, death occurs rarely, even in the largest and most complicated cases.

  • Postoperative Spinal Fluid Leak

In surgery, there is a risk of a temporary leak of cerebrospinal fluid (fluid surrounding the brain). This leak is closed prior to completion of surgery, usually with fat from the abdomen. However, approximately 3% to 5% of the time this leak reopens and further surgery may be necessary to close it. Most of the time, this leak can be closed by placing a drain in the cerebrospinal fluid space through the back. While this drain is in place the patient has to remain in bed, and in the vast majority of cases this stops the leak without further surgery.

  • Postoperative Infection

Postoperative infection occurs in approximately 3% of the patients. In a very small percentage of cases, an infection may involve only the external portion of the wound. When these complications occur, hospitalization is prolonged, and treatment with high doses of intravenous antibiotics is indicated. Occasionally, these antibiotics may cause an allergic reaction, suppress the body’s blood forming tissues, or may produce hearing loss in the good ear. Fortunately, antibiotic complications are rare.

  • Transfusion Reaction

Rarely, it is necessary to administer a blood transfusion during surgery. Adverse reactions to transfusions are rare. An occasional late complication is a viral infection of the liver (hepatitis). An even more rare complication is AIDS. Recent innovations in blood banking, however, have made this an extremely rare complication.

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10 common questions about Tympanoplasty surgery complications

1What happens after tympanoplasty surgery?
Ear pain and soreness are also common after surgery. These symptoms should go away during the first 3 to 5 days after surgery. Your doctor may prescribe pain medicine to take home for the first few days after surgery
2What is tympanoplasty surgery?
Tympanoplasty is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear (ossicles).
3How long does it take to recover from ear surgery?
It usually takes about 2 months for the ear canal to fully heal before water is allowed back into the ear. Because of swelling, fluid, and packing placed in the ear canal after surgery, hearing will be worse right after surgery
4Is Tympanoplasty a major surgery?
Tympanoplasty. A tympanoplasty is performed if the hole in your eardrum is large or if you have a chronic ear infection that cannot be cured with antibiotics. You will most likely be in the hospital for this surgery and will be placed under general anesthesia. You will be unconscious during this procedure
5Is a tympanoplasty painful?
Tympanoplasty (say "tim-PAN-oh-plass-tee") is surgery to repair a hole in the eardrum. ... You may feel dizzy for a few days after surgery. The cut (incision) the doctor made behind your ear may be sore, and you may have ear pain for about a week. Some bloody fluid may drain from your ear canal and the incision.
6How do you sleep after tympanoplasty?
RESUMING ACTIVITIES - It is advisable to sleep with the head of the bed elevated for the first week after surgery. This helps to minimize swelling behind the ear and in the middle ear cavity. The head of the bed may be elevated by sleeping on two or three pillows or by placing several pillows under the mattress
7Can Tympanoplasty restore hearing?
HEARING LOSS – A tympanoplasty is performed to help restore normal hearing. However, some hearing loss (more common with ossiculoplasty) may still be present after the procedure. An operation is termed successful if the hearing is restored within 10-15 decibels of normal
8How long after ear surgery Can you swim?
heart bypass surgery – you can swim after 3 months. cataract surgery – you should avoid swimming for 4 to 6 weeks. appendectomy (after having appendicitis) – you can swim after your stitches have been removed, the wound has healed and you have made a full recovery (usually at least 2 weeks)
9How long is tympanoplasty surgery?
Myringoplasty usually takes between 10 and 30 minutes. Tympanoplasty usually takes from 2 to 3 hours. Recovery from general anesthetic can take several hours. Your child might be prescribed medications after the surgery.
10How do you wash your hair after ear surgery?
You may shampoo your hair 48 hours after surgery carefully. Keep the ear canal dry with Vaseline impregnated cotton balls. Gently dry the hair with a towel and avoid vigorous rubbing over the incision area.

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