Tympanoplasty is a surgical procedure performed to reconstruct the eardrum when it has been badly torn or perforated. There are several reasons a tympanoplasty may need to be performed, including congenital deafness and injury to the tympanic membrane due to: serious or chronic middle ear infections, accidents, or extreme changes in air pressure.
Whenever there are symptoms of pain, discharge or bleeding from the ear, or hearing loss, a doctor should be consulted since these symptoms may be the result of eardrum perforation. Eardrum perforation is diagnosed by an examination of the ear using an instrument known as an otoscope. A hearing test is also often performed to evaluate whether the patient has sustained any hearing loss. Minor eardrum perforations may not require treatment since they will heal on their own. When the injury does not heal in a few weeks, a tympanoplasty is usually necessary.
During tympanoplasty the surgeon makes a cut either behind the ear or inside the ear canal. When the eardrum is perforated, there may be fractures of the small bones of the inner ear, called ossicles, as well. This happens frequently in children as a result of ear infections. When this occurs, the bones involved must be removed, repaired or replaced. If there is only a small hole in the eardrum, the doctor may be able to perform a lesser procedure, called a myringoplasty.
A tympanoplasty procedure is usually performed outpatient, meaning patients are able to return home later the same day.
While tympanoplasty is considered a safe and effective procedure, there are risks associated with any type of surgical procedure. Risks of a tympanoplasty may include: excessive bleeding, infection, breathing problems, adverse reaction to anesthesia, hearing loss and facial nerve injury. These complications are considered rare and are minimized by having an experienced and skilled surgeon perform the procedure. The symptoms experienced before the surgical procedure, such as hearing loss, usually abate quickly after the tympanoplasty procedure. During the period immediately following a tympanoplasty, patients should refrain from swimming, air travel and crowds.
Septoplasty is a surgical procedure to correct defects or deformities of the septum, the partition between the two nostrils. Commonly, the procedure is performed to correct a deviated septum. While a small deviation of the septum is commonplace, if the condition is more severe it may impede airflow through the nostrils. This may cause difficulty with nasal breathing and poor nasal drainage from the sinuses, both of which are problematic. During a septoplasty, the surgeon straightens the septum and repositions it to the center of the nose. The procedure may involve removing a small part of the septum itself.
In adults, it is composed of both cartilage and bone. The function of the nasal septum is to support the mucous membranes of the nose and to regulate air flow. A number of medical conditions may indicate a need for the procedure including nasal air passage obstruction, a deviated septum, tumors, chronic, uncontrolled nosebleeds or the presence of polyps. A septoplasty may also be performed in conjunction with a rhinoplasty in order to ensure that the reshaping of the nose does not result in a reduction of the amount of breathing space or in conjunction with sinus surgery to assist in post-surgical drainage.
Patients who have had a septoplasty can usually return home the same day or the morning after surgery. Risks or complications are relatively rare. During recovery, patients may experience bleeding, swelling, bruising, or discoloration.
Turbinate reduction is a surgical procedure to reduce the size of one or more of the small curved bones in the nose, known as turbinates, in order to open clogged nasal passages and improve breathing. There are three pairs of turbinates in the nose, classified as inferior, middle and superior. Their function is to warm, filter and humidify air as it circulates through the nose and into the lungs. Since they serve as filters, the turbinates help to protect the body from irritants and stave off infection.
Turbinate reduction is performed when a patient's turbinate is abnormally large, creating a nasal obstruction. The turbinates may swell in response to ear, nose and throat allergies or upper respiratory infections, resulting in a number of troubling symptoms which may include chronic nasal congestion, recurrent sinusitis, frequent nosebleeds and difficulty sleeping. If traditional treatments, such as nasal decongestants, antihistamines, allergy shots and antibiotics do not resolve these problems, surgical intervention is usually recommended.
Turbinate reduction may be performed using a few different surgical methods, depending on the patient's overall medical condition and the nature of the problem. The procedure is frequently performed in conjunction with corrective surgery for a deviated septum, known as a septectomy. Turbinate reduction is performed as an outpatient procedure and the patient should expect to resume a limited normal routine in approximately a week. While turbinate reduction operations are considered quite safe, there is always some risk involved in any surgical procedure.
Endoscopic sinus surgery is used to increase the amount of air flowing through the sinuses and allow mucus to drain properly out of the nose. The procedure can relieve nasal blockages, improve breathing, improve the sense of smell and taste and relieve facial pain. The endoscope, which utilizes fiberoptic technology, allows doctors to see inside the sinuses without cutting the face and makes it possible to see parts of the sinuses that were formerly difficult to reach. Dr. Wall received his training in sinus surgery at the University of Pennsylvania, the world’s leading center for sinus procedures. He has been involved in teaching these techniques to medical students, residents (doctors in training) and other surgeons for 15 years.