Hearing loss usually occurs against the background of inflammatory processes or age-related changes. Sometimes such symptoms indicate problems with the eardrum. This fragile structure is subject to various damages. In case of minor defects, it regenerates on its own. In other situations, restoration of the eardrum is required. According to doctors, surgery or non-surgical methods are used for this.
What is an eardrum?
The eardrum is the thinnest and impermeable to liquid and air membrane. It separates the outer ear from the middle. 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 as a result of mechanical stresses or pathological conditions. This leads to perforation - the formation of a gap and a hole. As a result, the transmission of sound vibrations is disrupted, the quality of hearing is affected. Perforation is also dangerous because pathogenic flora can penetrate through a hole in the middle ear cavity, causing various diseases. Timely restoration of the eardrum allows you to avoid these problems.
Causes of gaps
Membrane rupture 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:
- Household injuries that occur when cleaning the auricle with foreign objects (matches, needles, paper clips, etc.).
- Traumatic brain injuries.
- Exposure to high pressure (sneezing with a pinched nose, palm strike on the auricle, flying on an airplane).
- Work-related 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 membrane structure.
Signs of Injury
Immediately after rupture of the eardrum , severe pain occurs inside the auricle. Gradually, it subsides, giving way to a deterioration in the quality of hearing. Some note the appearance of a feeling of a foreign object and extraneous noise. With serious injury, not only severe pain occurs, but also dizziness. At the same time, from the auditory opening you can notice the allocation of a sacrum.
Damage Diagnostic Methods
If symptoms appear that indicate perforation of the eardrum, you must consult a traumatologist or otolaryngologist. After examining the affected area, otoscopy is performed. In the case of detection of defects in the membrane, they proceed to a more detailed diagnosis of pathology. It consists of the following events:
- stabilography;
- audiometry;
- vestibulometry;
- electrocochleography;
- acoustic impedancemetry;
- tuning fork research.
Comprehensive diagnosis allows you to assess potential damage and begin therapy. It can be surgical or non-surgical in nature.
What are the called eardrum repair operations?
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.
- Miringoplasty. The main indication is dry perforation of the eardrum. Intervention involves the closure of a defect by using healthy patient tissue taken from other areas.
- Prosthetics. Used for severe inflammation that affects the auditory ossicles. Damaged elements are repaired by means of plastic, cartilage or metal prostheses. Additionally, rehabilitation 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 even at the stage of diagnosis. However, if there is an inflammatory or infectious process, treatment should be carried out. This can be antibiotic therapy, washing with antiseptics or physiotherapy. After recovery, a period of 6 months should be maintained.
Surgery is performed using general anesthesia. Therefore, to identify possible contraindications to anesthesia, you need to consult with an anesthesiologist, do an ECG and fluorography. A week before surgery, you must stop taking blood-thinning drugs and non-steroidal anti-inflammatory drugs.
Stages of tympanoplasty
Tympanoplasty is a classic version of the operation to restore the eardrum. It is carried out in the area of the middle ear itself and has the following objectives:
- elimination of inflammation;
- the return of the anatomical position of the bones;
- membrane restoration.
During the intervention, the doctor makes a small incision behind the auricle, takes healthy tissue to replace the septum. If the auditory ossicles cannot be restored, prosthetics are used. At the final stage, the incision is sutured; the doctor sets up a tampon in the ear canal. Intervention lasts no more than 2 hours.
Features of myringoplasty
Meringoplasty 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 opening in the behind-the-ear space. The membrane is lifted and slightly pushed back, biological material is applied to the perforation site. It is fixed with special sponges. As a transplant, fascia of the temporal muscle can be used.
A drainage tube is installed through the ear canal. A swab dipped in an antibacterial solution is inserted into the ear. Damage healing period is up to 3 weeks. The wound behind the ear, from where the doctor took the material for the operation, is healed within a week. After this, the stitches are removed to the patient.
During the rehabilitation period, it is not recommended to blow your nose and sneeze in order to prevent the displacement of the membrane. The ear itself should be periodically treated with antiseptic solutions, antifungal drugs must be taken orally.
Recovery period
After surgery to restore the eardrum of the ear, it is recommended that you rest in the first two days. Therefore, patients are often left in the hospital after an intervention for 4-5 days. During this period, it is important to refrain from sudden movements and blowing your nose to avoid tissue injury. Retracting air can lead to displacement and rejection of the flap on the eardrum.
Within 7 days, antibacterial drugs are recommended to prevent infection of damaged tissues. Anemization is used to reduce swelling and prevent the accumulation of transudate. The procedure involves the introduction of vasoconstrictor drops into the Eustachian tube.
But these are not all limitations. Over the next 4-5 weeks, it is important to limit intense physical activity, weight lifting, air travel and swimming. You need to take a shower with extreme care to prevent water from entering your ear. You should sleep at least 8 hours, limit the intake of salty foods. So the body will recover much faster.
Contraindications for surgery
You can begin to restore the eardrum in the absence of the following health problems:
- Infectious diseases in the acute stage.
- Renal / liver failure.
- Blood clotting disorder.
- Uncompensated diabetes mellitus.
- Disorder of patency of the Eustachian tube.
- Heart failure.
Some contraindications are conditional. If eliminated, surgical intervention is allowed. For example, after otitis media, the restoration of the eardrum is possible after 6 months, but subject to the absence of relapse and in consultation with the doctor.
Possible complications
Complications after surgery are rare, but possible. The most serious ones include paralysis of the muscles of the face and the development of deafness. Less dangerous is a short-term increase in temperature, the appearance of shortness of breath, swelling in the area of the operation. If these symptoms persist for several days and are accompanied by discharge from the ear, you should consult a doctor.
With medical errors made during the operation, the occurrence of secondary perforation of the implant, its displacement is possible. Sometimes there is the formation of scars in the tympanic membrane. Such complications appear if the specialist has chosen the wrong treatment tactics, did not take into account the anatomical features of the inner ear, the patient’s allergic tendency and his age.
Non-surgical recovery methods
Restoring perforated eardrum without surgery is an alternative treatment and does not belong to evidence-based medicine. To stop the defect, Japanese scientists suggested using a sponge dipped 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 growth and tissue repair.
The sponge is inserted into the ear and fixed at the site of rupture of the membrane. Getting on damaged tissues, the secreted solution contributes to their regeneration. Full recovery occurs within 2-3 months. In this case, the sponge itself completely dissolves. Manipulation is necessarily carried out on an outpatient basis. It is completely painless and does not require the use of anesthesia.
This kind of restoration of the eardrum without surgery is already actively used today in different countries. Research methods were conducted at a scientific institute. 53 patients with perforation took part in it. In 52 people, therapy yielded positive results.
Patient Reviews
According to reviews, the operation to restore the eardrum is the only effective way to fix the problem. Patients admit that within a few days after the intervention, they notice positive changes: hearing problems, pain disappear. The rehabilitation process is rarely accompanied by complications, and the wound heals without problems.
The only drawback of this procedure is its high cost. The price for the 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 prestige of the medical institution itself.