The ear drum or the tympanic membrane lies inside the ear and stretches over the tiny bones in the ear. It helps in hearing. Sometimes it gets perforated and a small hole is created which results in pain, discharge, blood or loss of hearing. Eardrum perforations can occur due to injury or infection and is quite common in childhood. They are generally self-healing. If not, then healing by a doctor begins with drying the area, prescribing antibiotics, decongestants and eardrops and generally with all this, the perforation and the infection gets healed.
Sometimes swimming or flying with a heavy cold can result in ear infections, perforations and loss of hearing. External devices inserted in the area may cause perforations. Also frequent ear infections may be the cause of undetected eardrum perforations. If the perforation does not heal by these methods then a simple procedure can do it.
The ear drum reconstruction can be done by first anesthetizing the edges of the eardrum with xylocaine or any such medicine. The undersurface of the eardrum is then scratched with a sharp right-angled hook. This stimulates the eardrum to heal. Sometimes placing patches on the outer surface of the eardrum will make it heal. Tympanoplasty is the microsurgery which closes and heals the perforation. It is often done on an outpatient basis where the patient can go home on the same day. Long-standing perforations are a result of severe infection and the resultant erosion of the ear bones. An audiogram (hearing test) is taken to find out the degree of hearing loss. If it is mild then patching of the hole will improve it and reconstruction of the eardrum will be a curative procedure.
If the hearing loss is more, it may affect the mastoid bone. A CT scan may be necessary for the reconstruction procedure to be done. Surgery can be done under local or deep anesthesia. An incision is made in the ear canal and the remaining eardrum is elevated away from the bones and lifted. The operating microscope will show the details of the perforation. If it is very large or too far away, it may be necessary to make an incision behind the ear. The microsurgery can now be done with laser technique or by incisions and sutures. These sutures are self-absorbing. The ear will be covered and the patient sent to the recovery room. The patient should take care that no water reaches the place of the procedure and that blowing of the nose should not be done. After about two weeks the dressing can be removed and a hearing test may be done. Ninety percent of such reconstruction cases are successful. |
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