Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch
CPT4 code
Name of the Procedure:
Tympanic Membrane Repair (Myringoplasty or Tympanoplasty)
Summary
Tympanic membrane repair, commonly known as Myringoplasty or Tympanoplasty, is a surgical procedure intended to fix a perforated (torn) eardrum. The repair can be done with or without prior site preparation and may involve using a patch to cover the hole.
Purpose
This procedure addresses a perforation in the tympanic membrane (eardrum) which can result from infections, injuries, or chronic ear diseases. The primary goal is to restore the integrity of the eardrum to improve hearing, prevent recurrent ear infections, and stop ear discharge.
Indications
- Recurrent ear infections
- Hearing loss due to eardrum perforation
- Persistent ear discharge
- Patients with chronic otitis media
Preparation
- Patients may need to fast for several hours before surgery.
- The healthcare provider may adjust or discontinue certain medications.
- Audiometric tests and a physical examination of the ear.
Procedure Description
- The patient is administered local or general anesthesia.
- The surgeon makes an incision to access the eardrum.
- The edges of the perforation are prepared by removing dead tissue.
- A patch, often taken from the patient's own tissue (e.g., fascia or fat), is placed over the perforation.
- The incision is closed, and the ear is bandaged.
Tools used include microscopes for precision, micro-dissection instruments, and graft materials.
Duration
The procedure typically lasts between 1 to 2 hours.
Setting
This procedure is performed in a hospital or an outpatient surgical center.
Personnel
- ENT (Ear, Nose, and Throat) surgeon
- Surgical nurses
- Anesthesiologist
Risks and Complications
- Infection
- Bleeding
- Hearing loss
- Dizziness
- Failure of the eardrum to heal properly
- Allergic reactions to anesthesia
Benefits
- Improved hearing
- Reduction or elimination of ear discharge
- Prevention of recurrent ear infections
Benefits can be realized in a few weeks to months after the procedure as healing occurs.
Recovery
- Patients may need to keep the operated ear dry for a few weeks.
- Pain and discomfort are usually managed with prescribed medications.
- Follow-up appointments are crucial to monitor healing.
- Avoid heavy lifting and strenuous activities for several weeks.
Alternatives
- Observation: For small perforations that might heal on their own.
- Hearing aids: To manage hearing loss without surgery.
- Chemical cautery: Applying a chemical to stimulate the edge of the perforation to heal.
Patient Experience
During the procedure, patients under local anesthesia may feel minor pressures or pulling sensations, while general anesthesia will keep them unconscious. Pain and discomfort post-surgery are managed with over-the-counter or prescription pain relievers. Keeping the ear dry and following the surgeon's care instructions are vital for a smooth recovery.