Selection of Videos about Tympanic Perforations

Fixing a Hole in the Ear (Tympanoplasty / Myringoplasty)

Tympanoplasty is a surgery to fix a hole in the eardrum. This hole can be caused by infections or injuries. During the procedure, the surgeon uses a small piece of tissue, usually taken from the patient, to cover and close the hole. This helps to improve hearing, stop ear infections, and keep the ear healthy. In this video, you will see the step-by-step process of how tympanoplasty is done.

Watch this video to see the operation and description.

Professor Vik Veer discusses how to treat ear hole tympanic perforation holes

How to use Ear Drops Correctly.

Using ear drops correctly is essential for maintaining ear health and ensuring effective treatment. Proper use helps prevent complications and maximises the medication's benefits. Misuse can lead to ineffective treatment, further ear problems, or even potential infections.

Understanding and following the correct procedure is crucial in achieving the best results and keeping your ears in good condition.

Dr Vik Veer discusses how to treat ear infections with ear drops

Which Ear Drop is Best for Wax?

In this video, I'll test different ear drops on ear wax samples collected in test tubes, using a time-lapse camera to capture the results. By comparing how each product performs, we aim to identify the best solution for removing ear wax.

You may be suprised by the results for olive oil.

Dr Vik Veer discusses how to treat ear wax

What is Cholesteatoma?

A cholesteatoma is an abnormal growth of skin cells that occurs behind the eardrum, in the middle ear, or within the mastoid bone. This growth can gradually expand, leading to the destruction of nearby structures, such as the bones of the middle ear, which are crucial for hearing. If left untreated, they can cause hearing loss, dizziness, and even more serious complications. Surgical removal, such as a mastoid operation, is often needed to prevent further damage and restore ear health.

Watch this video to learn more.

Dr Vik Veer discusses how to treat cholesteatoma

Eustachian Tube Dysfunction

Eustachian tube dysfunction (ETD) occurs when the tube connecting the middle ear to the back of the nose becomes blocked or does not function properly. This can lead to symptoms such as ear fullness, pain, hearing difficulties, and tinnitus. The eustachian tube's role is to equalise pressure between the middle ear and the external environment. When it malfunctions, pressure differences can cause discomfort and other issues.

This video explains this condition and what the treatment options are.

Dr Vik Veer discusses how to treat sleep apnoea

Devices that help with Eustachian Tube Dysfunction

Valsalva device treatments, such as Otovent balloons and Ear Popper devices, offer non-invasive solutions for eustachian tube dysfunction. These devices help open the eustachian tubes, equalising pressure and alleviating symptoms like ear fullness and discomfort.

These treatments are simple, effective, and can be used at home to provide relief from eustachian tube dysfunction symptoms.

Dr Vik Veer discusses how to treat sleep apnoea

Balloon Treatment for Eustachian Tube

This a condition where the tube connecting your ear to the back of your nose becomes blocked or doesn't open properly. People feel like their hearing is blocked and crackles when they pop their ears.

During this procedure, a small balloon is inserted into the eustachian tube through the nose and gently inflated to open the tube. The procedure is typically quick, with most patients returning to normal activities after an hour or so.

Dr Vik Veer discusses how to treat sleep apnoea

Watch a Mastoid Operation

A mastoid operation for cholesteatoma involves surgically removing the abnormal skin growth located in the middle ear and mastoid bone. The cholesteatoma is carefully extracted, taking care to preserve essential ear structures to maintain hearing function. In some cases, a tympanoplasty, or repair of the eardrum, is also performed to restore the integrity of the ear.

Watch this operation in this video.

Dr Vik Veer discusses how to treat cholesteatoma with mastoidectomy

Otosclerosis and Stapedectomy

Otosclerosis is a condition affecting the bones in the middle ear, leading to progressive hearing loss. It occurs when abnormal bone growth develops around the stapes, one of the tiny bones in the ear that helps transmit sound to the inner ear. This bone growth prevents the stapes from vibrating properly, resulting in reduced sound transmission and hearing difficulties.

Watch this video to learn more about treatment operations.

Professor Vik Veer discusses how to treat ear Otosclerosis and Stapedectomy

Treating Ear Drum Perforations

Tympanoplasty (Myringoplasty) Repair of Ear Drum Hole

This is an operation to close a hole in the ear drum. There are many different ways of performing this operation, but generally Mr Vik Veer prefers to avoid any scars around the ear, keeping all the incisions within the ear canal. This seems to be less painful for patients and also avoids shaving any hair or leaving any scars.

tympanic-perforation An ear drum perforation can occur for a number of different reasons. Occasionally this is because of injury to the ear drum from something pushed through the delicate membrane such as a cotton bud or hair pin. More commonly a perforation occurs because of a infection in the middle ear which tears through the ear drum. Generally this ear infection leads to terrible pain and hearing loss in the ear followed by a sudden discharge of pus from that ear. After a day or so the pain improves but there is still hearing loss and sometimes discharge from the ear.

Often patients with discharge from the ear are given oral antibiotics, but in actual fact you should be given antibiotic ear drops. There is good evidence that drops are the right treatment, and there are drops that do not cause hearing loss. 98% of Ear drum perforations heal up within 3 months, so before considering an operation for this, patients should wait for 3 months at least.

There are many different operations for repairing the ear drum, and the basics of these operations are provided below

Underlay Tympanoplasty
tympanic-perforation The most common operation in England for ear drum performation is called the underlay tympanoplasty. This operation can be done without any scars outside the ear, but in some types of perforations (those that are difficult to see), need to be repaired with a scar either infront of the ear (rare) or behind the ear.

As you can see a layer of fascia is used to support the hole in the ear drum. Fascia in medical terms is a thin layer of tissue found on the surface of muscle or cartilage. This fascia can be collected from cartilage or muscles around the ear and used to cover the hole in the ear. This fascia acts as a support for the perforation, it doesn't actually plug the hole. The fascia will eventually reabsorb over several months. The way the operation works is that the hole in the ear drum is altered in such a way that it starts healing again. This healing process is more likely to work if there is something for the ear drum to grow across. This is what the fascia is used for, as a scaffolding for the healing ear drum.

Sometimes the ear drum can be further supported with a piece of cartilage (green block), which lasts much longer than fascia and means that the success rate of blocking the ear perforation is higher. Having a piece of cartilage in the ear however may mean that the hearing is not as good as a normal as just fascia. Cartilage is normally recommended in ears which keep getting infected or where the patient finds it difficult to pop the ears.

Onlay Tympanoplasty
tympanic-perforation OnLay is a poor way of describing this operation. In actual fact the skin that lines the ear canal and the skin on the other side of the ear drum (that covers the middle ear) are separated and the space between them is seen. The fasica is then placed inbetween the layers of the ear drum (like a sandwich), and allowed to heal that way. Occasionally you can use cartilage in this technique as well.

This type of operation is rarely done in this country, but this technique is very common in America. Mr Vik Veer uses both onlay and underlay techniques frequently, and the decision is normally made during the operation.

The Butterfly technique
tympanic-perforation This technique is rarely used. Mr Vik Veer uses this to plug a hole, rather than allow the natural healing of the ear drum. This operation is useful in cases when a simple operation is needed to avoid a long general anaesthetic.

The hearing outcomes aren't quite as good, but it is a quick operation and you do not need to rely on the healing of the ear drum for the operation to work.

This operation is especially useful for patients who are completely fed up as they have had lots of operations with no success.

Again the decision to go ahead with this operation is only really made during the operation, but the pros and cons can be discussed beforehand.

Cartilage techniques
tympanic-perforation tympanic-perforation When cartilage is needed for an operation, there is an added layer of complexity that can be discussed. The cartilage can be placed without any refinement to cover the entire ear drum. This gives a solid covering of the ear drum hole and probably provides the best chance of blocking the hole long term. The Cambridge team uses this technique and their results suggest that it doesn't affect the hearing as much as one would expect

The Palisade technique is an attempt to reduce the bulk of the cartilage to give even better hearing results whilst also providing the benefits of using cartilage. The best of both worlds.

Again this decision is made during the operation, but this technique and the many others that are not recorded here can be discussed in clinic.



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