Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction
CPT4 code
Name of the Procedure:
Tympanoplasty without mastoidectomy
Also known as: Eardrum repair, Tympanic membrane repair
Summary
Tympanoplasty without mastoidectomy is a surgical procedure that repairs the eardrum (tympanic membrane) without involving the mastoid bone. This process may include canalplasty (reshaping the ear canal), atticotomy (removing part of the ear's attic), and/or middle ear surgery, without reconstructing the ossicular chain (tiny bones in the middle ear).
Purpose
This procedure is used to address issues related to a perforated eardrum or chronic ear infections that have not responded to other treatments. The goal is to restore the integrity of the eardrum to improve hearing, reduce the risk of infection, and alleviate discomfort.
Indications
- Perforated eardrum
- Chronic otitis media (middle ear infections)
- Hearing loss due to tympanic membrane damage
- Persistent ear drainage not responsive to medical treatment
Preparation
- Fasting for 6-8 hours before the procedure.
- Temporarily stopping certain medications, as advised by the doctor.
- Preoperative hearing tests and imaging studies like a CT scan.
Procedure Description
- Anesthesia: The patient is given general or local anesthesia.
- Incision: A small incision is made in the ear canal.
- Access: The surgeon may perform a canalplasty to enlarge the ear canal.
- Repair: The eardrum is repaired using graft tissue taken from another part of the patient’s body or a synthetic material.
- Additional Procedures: Atticotomy or middle ear surgery may be performed if needed.
- Closure: The incision is closed, and a sterile dressing is applied.
Duration
The procedure typically takes about 2 to 3 hours.
Setting
Performed in a hospital or outpatient surgical center.
Personnel
- ENT surgeon (Otolaryngologist)
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection
- Bleeding
- Temporary or permanent hearing loss
- Dizziness or balance issues
- Tinnitus (ringing in the ear)
- Graft failure or eardrum re-perforation
Benefits
- Improved hearing
- Reduced frequency of ear infections
- Alleviation of ear discharge and discomfort
The benefits are often realized gradually over a few weeks to months.
Recovery
- Keep the ear dry and avoid water exposure.
- Use prescribed ear drops and medications.
- Follow-up appointments for monitoring and removal of packing material.
- Avoid heavy lifting or straining for a few weeks.
- Recovery period usually ranges from 2 to 4 weeks.
Alternatives
- Watchful waiting: Particularly for minor perforations that might heal naturally.
- Hearing aids: For non-surgical management of hearing loss.
- Non-surgical intervention: Use of antibiotics or ear drops for treating infections.
Patient Experience
Patients will likely feel drowsy from anesthesia immediately after the procedure. Some discomfort or mild pain is common, but can be managed with prescribed pain medications. Full recovery typically occurs within a few weeks, and patients may experience gradual improvement in hearing and a reduction in ear symptoms.