Tympanoplasty
Overview
Tympanoplasty is a surgical procedure to repair a perforated tympanic membrane and, where necessary, reconstruct the ossicular chain. The primary goals are restoration of hearing and elimination of chronic middle-ear disease.
Procedure outline
- 1
Patient positioned supine with head rotated away from operative ear; local anaesthetic with adrenaline infiltrated into the external auditory canal.
- 2
Tympanomeatal flap elevated using a flap knife or sickle knife to expose the middle-ear space.
- 3
Middle-ear explored; pathological tissue, granulations, and cholesteatoma remnants removed with micro cup forceps and suction.
- 4
Graft material harvested — typically temporalis fascia or tragal perichondrium — and prepared on a drumhead.
- 5
Graft placed underlay (medial to tympanic membrane remnant) or overlay depending on perforation size and surgeon preference.
- 6
Tympanomeatal flap repositioned over the graft; gel foam packing placed in the external canal to support the graft.
- 7
Wound closed and canal dressed.
Instrument set
Complete Instrument Set
Complete Tympanoplasty instrument set from Netcare Instruments.
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Book a DemoTympanoplasty is one of the most commonly performed otological procedures. Success rates exceed 85% in favourable cases (dry ear, central perforation, intact ossicular chain). Results depend on surgeon experience, graft selection, and control of pre-operative middle-ear infection.
Indications
- Chronic tympanic membrane perforation (traumatic or post-infective)
- Conductive hearing loss attributable to tympanic membrane pathology
- Recurrent otorrhoea through a persistent perforation
- Preparation for ossicular reconstruction (combined approach)
Graft options
| Graft | Advantages | Notes |
|---|---|---|
| Temporalis fascia | Abundant, thin, low donor morbidity | Most widely used |
| Tragal perichondrium | Stiff — useful for atelectatic drum | Smaller harvest area |
| Cartilage + perichondrium | High success in revision cases | Slight mass effect on hearing |
The instrument set
The Micro Ear Cup Forceps is a central instrument in the tympanoplasty tray, used in steps 3 and 5 above for granulation clearance and graft manipulation. The full instrument set — including elevators, suctions, and specula — is available as a bundled set from Netcare Instruments.
Related
Instruments
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