Who needs eardrum repair?

Posted on 1 December 2017

For many children who suffer from headaches, vertigo and tinnitus, tympanoplasty (eardrum repair) is music to the ears.

Otherwise known as eardrum repair surgery, tympanoplasty is a procedure surgeons will perform to treat the effects of damage to the eardrum.

The tympanic membrane is a thin piece of tissue that separates your ear canal from the middle ear. If it is damaged or ruptured, this could lead to a loss of hearing.

Damage to the eardrum is especially prevalent in children, and is most often caused by infection. In fact it is estimated that five out of every six children will experience an ear infection before they turn three years old. This is because their immature ear canals are unable to drain as well as an adult’s would, and their vulnerable immune systems make them more prone to infections in general.

While children everywhere suffer from ear infections, this tends to be more a serious trend in the developing world. Dr Leon Nel, an ear, nose and throat specialist surgeon at Mediclinic Vergelegen, says that without adequate access to quality healthcare, children are at risk of repeat infections.

An ear infection (or acute otitis media) is caused when fluids build up in the middle ear, an air-filled space just behind the eardrum. This build-up leads to pressure, and that causes inflammation and pain.

Runny ears are another common symptom of ear infection. This discharge might appear as a clear liquid, yellow pus or even bloody drainage. Ringing in the ear (tinnitus) is another symptom, while vertigo – together with the loss of balance, nausea and vomiting it can cause – is not uncommon either.

An outer ear infection, caused by a build-up of water in the ear canal, for example, can damage the middle ear too. While this is easily treated with medication, repeat infections can cause permanent damage – and when this happens, surgery becomes a necessary intervention.

‘Infections undermine the ear’s ability to look after itself,’ says Dr Nel. ‘Children who require tympanoplasty will have holes in their eardrums, most likely due to repeated infections.’

The surgery consists of two parts: doctors patch the hole before reinforcing the membrane. ‘As a rule, we harvest a piece of cartilage from the earlobe and place it under the eardrum as a scaffolding,’ Dr Nel explains. ‘This becomes incorporated in the drum and allows the skin the grow over and close the hole.’

If this sounds painfully invasive, it could be worse: ‘We used to have to make an incision behind the ear and pull the whole ear forward to make the graft, then stitch the ear back,’ Dr Nel adds. ‘Because it causes a bigger wound, this would take a lot longer to heal. Thankfully the technology has progressed to the point where we can now go directly through the ear canal opening to perform the surgery.’

Your sense of hearing is an important part of how you experience the world. ‘By allowing children to hear better, tympanoplasty can give them a better chance in life and in their education,’ Dr Nel says.

‘But most importantly the surgery will help them lead healthier lives: they’ll be able to play sport and won’t have to deal with runny ears. This is the kind of surgery than can make a huge difference to a child’s quality of life.’


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In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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