Tympanoplasty

The tympanoplasty ( gr tympanon " cymbal"; tympanic cavity of the ear; Plastic: surgical repair ) is surgery of the ear, in the ear drum ( tympanic membrane, Myrinx ) and ossicular chain are restored.

Required is the tympanoplasty with a permanent tympanic membrane perforation or defects of the ossicular chain, especially by injury, inflammation, or cholesteatoma.

During surgery for reconstruction of the tympanic membrane usually the body's own tissue is used, usually fascia ( fascia ) of the temporalis muscle or cartilage skin ( perichondrium ) from the tragus or pinna. For replacement of the ossicles residuals of the ossicles of the patient or prostheses made ​​of different materials such as ceramic or titanium are used.

History of tympanoplasty

With Joseph Toynbee (1815-1866), the science-based otology began by creating through his investigations on the pathological anatomy of the ear a sound basis. Emil Berthold (1837-1906) tried to cover a surgically eardrum defect for the first time. He called the process Myringoplastik.Berthold used an explanted piece of tissue from the upper arm skin that he uniformly andrückte after appropriate pre-treatment with the wound surface on the eardrum edge so that the perforation was evenly covered. The external auditory canal was then carefully filled with cotton wool without moving the graft case. Later Berhold used, according to experiments with different materials, the outer egg membrane ( outer shell skin) of a chicken egg while the results were of great variation. Rudolf Haug, a Munich-based assistant doctor found out that it was crucial that side of the amniotic membrane was placed on the tympanic membrane defect.

There are some slightly different classifications of tympanoplasty according to the extent of the reconstruction, which originally date back to Horst Ludwig Wullstein. After a common classification is distinguished:

  • Myringoplasty: Exclusive restoration of the tympanic membrane.
  • Type I: restoration of the tympanic membrane and rehabilitated measures in the middle ear with intact ossicular chain.
  • Type II: restoration of the ossicular chain (and possibly of the tympanic membrane ) with an intact stapes ( stapes ).
  • Type III: restoration of the ossicular chain (and possibly of the tympanic membrane ) with a defective stirrup ( stapes ).
  • Type IV: cover the round window for soundproofing (sound protection ).
Tragus (ear) Digital Object Identifier
589450
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