博仁國際醫療
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Outpatient Endoscopic Tympanoplasty
Outpatient endoscopic tympanoplasty is a promising medical service. The indication of the operation includes all-sized perforations of the tympanic membrane. The operation is performed under local and intravenous anesthesia, and general anesthesia is not required. Currently, Dr. Tseng has performed more than 300 operations, and the average success rate is over 95%. After operation, patients can fly back to their own country, which is convenient for foreign country patients.
The tympanic membrane, or ear drum, may need surgical repair when punctured (A). During a type I tympanoplasty, a perforation in the ear drum is visualized (B). A tissue graft is placed over the perforation (C) and held in place by the existing ear drum (D). (Illustration by GGS Inc.)
The tympanic membrane, or ear drum, may need surgical repair when punctured (A). During a type I tympanoplasty, a perforation in the ear drum is visualized (B). A tissue graft is placed over the perforation (C) and held in place by the existing ear drum (D).
 

Risks
Possible complications include failure of the graft to heal, causing recurrent eardrum perforation; narrowing (stenosis) of the ear canal; scarring or adhesions in the middle ear; perilymph fistula and hearing loss; erosion or extrusion of the prosthesis; dislocation of the prosthesis; and facial nerve injury. Other problems such as recurrence of cholesteatoma, may or may not result from the surgery.
Tinnitus (noises in the ear), particularly echo-type noises, may be present as a result of the perforation itself. Usually, with improvement in hearing and closure of the eardrum, the tinnitus resolves. In some cases, however, it may worsen after the operation. It is rare for the tinnitus to be permanent after surgery.


Aftercare
Generally, the patient can return home within two to three hours. Antibiotics are given, along with a mild pain reliever. After 10 days, the packing is removed and the ear is evaluated to see if the graft was successful. Water is kept away from the ear, and nose blowing is discouraged. If there are allegies or a cold, antibiotics and a decongestant are usually prescribed. Most patients can return to work after five or six days, or two to three weeks if they perform heavy physical labor. After three weeks, all packing is completely removed under the operating microscope. It is then determined whether or not the graft has fully taken.
Post-operative care is also designed to keep the patient comfortable. Infection is generally prevented by soaking the ear canal with antibiotics. To heal, the graft must be kept free from infection, and must not experience shearing forces or excessive tension. Activities that change the tympanic pressure are forbidden, such as sneezing with the mouth shut, using a straw to drink, or heavy nose blowing. A complete hearing test is performed four to six weeks after the operation.


Successful Case
Mr. Wang suffered from left eardrum perforation for many years. His symptoms include hearing loss and excessive discharge from the ear. Microscopic examination shows that over 80% of his left eardrum has been destroyed.
 
Dr. Tseng performed minimal invasive endoscopic Tympanoplasty in his left eardrum. With minimal surgical wound and shortened recovery process, his left ear stopped excreting pus and post-op hearing examination results returned to normal.