Tympanoplasty

Tympanoplasty
Intervention
Before and after a tympanoplasty.
ICD-9-CM	19.4-19.5
MeSH	D014433
[]

Tympanoplasty is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear (ossicles).

Tympanoplasty is classified into five different types, originally described by Horst Ludwig Wullstein (1906–1987) in 1956.

The term 'myringoplasty' refers to repair of the tympanic membrane alone.

There are several options for treating a perforated eardrum. If the perforation is from recent trauma, many ear, nose and throat specialists will elect to watch and see if it heals on its own. After that, surgery may be considered.

Tympanoplasty can be performed through the ear canal (transcanal approach), through an incision in the ear (endaural approach) or through an incision behind the ear (postauricular approach).

A graft may be taken to reconstruct the tympanic membrane. Common graft sites include the temporalis fascia and the tragus.

The surgery takes ½ to 1 hour if done through the ear canal and 2⅓ to 3 hours if an incision is needed. It is done under local or general anesthesia. It is done on an inpatient or day case basis and is successful 85-90% of the time.

The first recorded attempt at repairing the tympanic membrane was made by Marcus Banzer in 1640 using an ivory tube covered by pig's bladder.

In the middle of the nineteenth century the British otologists James Yearsley and Joseph Toynbee each developed their own form of artificial eardrum. Despite initial enthusiasm for these devices, experience amongst the medical profession over the following half century demonstrated their minimal value in the treatment of a perforated eardrum, which generally heals naturally.