Hearing loss usually occurs against the background of inflammation or age-related changes. Sometimes these symptoms indicate problems with the eardrum. This fragile structure is subject to various damages. In case of minor defects, it regenerates itself. In other situations, restoration of the eardrum is required. According to doctors, surgical intervention or non-surgical methods are used for this.
What is the eardrum?
The eardrum is the thinnest membrane that is impermeable to liquid and air. It separates the outer ear from the middle ear. It has 2 important functions in the human body: the transmission of sound vibrations and the protection of the cavity from the penetration of foreign substances.
The structure of the eardrum is very delicate. Therefore, it is easily damaged bymechanical influences or pathological conditions. This leads to perforation - the formation of a gap and a hole. As a result, the transmission of sound vibrations is disturbed, the quality of hearing suffers. Perforation is also dangerous because pathogenic flora can penetrate into the middle ear cavity through a kind of hole, causing various kinds of diseases. Timely repair of the eardrum avoids these problems.
Reason for breakups
Rupture of the membrane occurs quite often, not only in adults but also in children. The following factors can lead to a violation of the integrity of the structure:
- Domestic injuries that occur when cleaning the auricle with foreign objects (matches, needles, paper clips, etc.).
- Tranio-cerebral injuries.
- Exposure to high pressure (sneezing with a pinched nose, hitting the ear with the palm of the hand, flying in an airplane).
- Industrial injuries while working in a pressure chamber.
- Chemical and thermal burns.
- Inflammation of the middle ear.
The impact of even one of the above factors violates the integrity of the structure of the membrane.
Signs of injury
Immediately after the rupture of the eardrum, there is severe pain inside the auricle. Gradually, it subsides, replaced by a deterioration in the quality of hearing. Some note the appearance of a feeling of a foreign object and extraneous noise. With a serious injury, there is not only a strongpain syndrome, but also dizziness. At the same time, the secretion of the ichorus can be seen from the auditory opening.
Methods for diagnosing damage
If you experience symptoms that indicate a perforation of the eardrum, you should consult a traumatologist or an otolaryngologist. After examining the affected area, an otoscopy is performed. In case of detection of membrane defects, they proceed to a more detailed diagnosis of the pathology. It consists of the following activities:
- stabilography;
- audiometry;
- vestibulometry;
- electrocochleography;
- acoustic impedancemetry;
- tuning fork.
Comprehensive diagnostics allows you to assess potential damage and start therapy. It can be surgical or non-surgical.
What is eardrum surgery called?
Depending on the severity of the pathological process, the following types of interventions are performed:
- Tympanoplasty. A complex procedure that is prescribed to improve the sound-conducting functions of the tympanic cavity.
- Myringoplasty. The main indication is dry perforation of the tympanic membrane. The intervention involves closing the defect by using he althy tissues of the patient taken from other areas.
- Prosthetics. It is used for severe inflammation that has affected the auditory ossicles. Damaged elements are restored using plastic, cartilage or metal prostheses. Additionally, sanitation of the ear cavity is carried out.
Preparation for surgery
Specific preparation for surgical intervention is not required, since the patient undergoes the necessary examination at the stage of diagnosis. However, if there is an inflammatory or infectious process, treatment should be carried out. This may be antibiotic therapy, washing with antiseptics or physiotherapy. After recovery, a period of 6 months should be maintained.
Surgery is performed under general anesthesia. Therefore, to identify possible contraindications to anesthesia, you need to consult with an anesthesiologist, make an ECG and fluorography. Blood thinners and non-steroidal anti-inflammatory drugs should be stopped a week before surgery.
Tympanoplasty steps
Tympanoplasty is a classic version of eardrum repair surgery. It is carried out in the region of the middle ear itself and has the following goals:
- eliminate inflammation;
- return of the anatomical position of the bones;
- restoration of the eardrum.
During the intervention, the doctor makes a small incision behind the auricle, takes he althy tissues to replace the septum. If the auditory ossicles cannot be restored, prosthetics are used. At the final stage, the incision is sutured, and the doctor inserts a tampon into the ear canal. Interventionlasts no more than 2 hours.
Features of myringoplasty
Myringoplasty is performed to restore the eardrum and involves the use of special microscopic instruments. During the operation, the doctor first takes tissue samples to suture the hole behind the ear. The membrane is lifted and slightly moved away, biological material is applied to the perforation site. It is fixed with special sponges. The fascia of the temporalis muscle can be used as a graft.
A drainage tube is placed through the ear canal. A swab soaked in an antibacterial solution is inserted into the ear. The healing time of the injury is up to 3 weeks. The wound behind the ear, where the doctor took the material for the operation, heals within a week. After that, the stitches are removed for the patient.
During the rehabilitation period, it is not recommended to blow your nose and sneeze to prevent membrane displacement. The ear itself should be periodically treated with antiseptic solutions, oral antifungal drugs should be taken.
Recovery period
After the operation to restore the eardrum, it is recommended to remain calm for the first two days. Therefore, patients are often left in the hospital after the intervention for 4-5 days. During this period, it is important to refrain from sudden movements and blowing your nose to avoid tissue injury. The inhalation of air can lead to displacement and rejection of the flap on the tympanic membrane.
Within 7 daysrecommended taking antibacterial drugs to prevent infection of damaged tissues. To reduce swelling and prevent the accumulation of transudate, anemization is used. The procedure involves the introduction of vasoconstrictor drops into the Eustachian tube.
But these are not all restrictions. Over the next 4-5 weeks, it is important to limit intense exercise, heavy lifting, air travel and swimming. Take a shower very carefully to prevent water from entering the ear. Sleep should be at least 8 hours, limit the intake of s alty foods. So the body will recover much faster.
Contraindications for surgery
You can start repairing your eardrum in the absence of the following he alth problems:
- Infectious diseases in the acute stage.
- Renal/liver failure.
- A bleeding disorder.
- Uncompensated diabetes mellitus.
- Eustachian tube patency disorder.
- Heart failure.
Some contraindications are conditional. In case of their elimination, surgical intervention is allowed. For example, after otitis media, the restoration of the eardrum is possible after 6 months, but provided that there is no recurrence and in agreement with the doctor.
Possible Complications
Complications after surgery are rare, but possible. The most serious include paralysis of the muscles of the face and the development of deafness. Lessa short-term increase in temperature, the appearance of shortness of breath, swelling in the area of the operation is considered dangerous. If these symptoms persist for several days and are accompanied by discharge from the ear, you should consult a doctor.
In case of medical errors made during the operation, secondary perforation of the implant and its displacement may occur. Sometimes there is scar formation in the tympanic membrane. Such complications appear if the specialist chose the wrong treatment tactics, did not take into account the anatomical features of the inner ear, the patient's tendency to allergies and his age.
Non-surgical recovery methods
Eardrum perforation repair without surgery is an alternative treatment and does not belong to evidence-based medicine. To stop the defect, Japanese scientists proposed using a sponge soaked in a special solution. Its size in diameter does not exceed 0.5 cm. The solution is a mixture of animal fibroblasts that produce elastin and collagen. They help the process of tissue growth and repair.
A sponge is inserted into the ear and fixed at the site of the rupture of the membrane. Getting on the damaged tissues, the secreted solution promotes their regeneration. Full recovery occurs within 2-3 months. In this case, the sponge itself is completely dissolved. Manipulation is necessarily carried out on an outpatient basis. It is completely painless and does not require the use of anesthesia.
This kind of reconstruction of the eardrum without surgery is already actively used in different countries today. Research methods were carried out in a scientific institute. It involved 53 patients with perforation. In 52 people, therapy gave positive results.
Patient testimonials
According to reviews, eardrum repair surgery is the only effective way to fix the problem. Patients admit that already a few days after the intervention they notice positive changes: hearing problems and pain disappear. The rehabilitation process is rarely accompanied by complications, and the wound heals without problems.
The only drawback of such a procedure is the high cost. The price for an operation to restore the eardrum can vary up to 50 to 100 thousand rubles. This variation is due to the list of services provided, the qualifications of the doctor and the direct prestige of the medical institution.
