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Tympanoplasty is the surgical technique of removal of the retracted area from the middle ear and reconstruction of the tympanic membrane. Some surgeons use cartilage (taken from the outer ear) to stiffen the eardrum with the aim of preventing further retraction. [9] Surgical removal is required once a cholesteatoma has formed.
A type 1 tympanoplasty is synonymous to myringoplasty. Type 2 involves repair of the tympanic membrane and middle ear in spite of slight defects in the middle ear ossicles . Type 3 involves removal of ossicles and epitympanum when there are large defects of the malleus and incus.
Whilst hearing loss is a common symptom in many diseases of the ear, for example in otosclerosis (abnormal bone growth in the ear), [3] the white, chalky patches on the tympanic membrane are fairly characteristic of tympanosclerosis. Cholesteatoma is similar in appearance but the whiteness is behind the tympanic membrane, rather than inside.
Stapedectomy is a surgical procedure in which the stapes bone is removed from the middle ear and replaced with a prosthesis.. If the stapes footplate is fixed in position, rather than being normally mobile, the result is a conductive hearing loss.
[1] [2] [3] When myringoplasty is combined with removal of scar tissue, it is called tympanoplasty. The operation is performed with the patient supine and face turned to one side. The graft material most commonly used for the surgery is temporalis fascia. The tragal cartilage [1] and tragal perichondrium are also used as the graft by some surgeons.
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The ear is washed and a small incision made in the eardrum. Any fluid that is present is then aspirated, the tube of choice inserted, and the ear packed with cotton to control any slight bleeding that might occur. This is known as conventional (or cold knife) myringotomy and usually heals in one to two days. [13]