Hearing improvement surgery (tympanoplasty)

Chronic infection in the ear can cause troublesome ear discharge, affect the eardrum and ossicles and can cause hearing loss.

Which diseases of the middle ear cause hearing loss?

Hearing loss can in some cases be due to chronic otitis media or cholesteatoma – also called bone decay. 
 
Chronic otitis media can be seen when there is a perforation in the eardrum. Through the perforation, bacteria from the ear canal can gain access to the middle ear and cause infection with ear discharge, pain and bad odour. Often there is also hearing loss. The hearing loss is due to the infection itself; the perforation in the eardrum; or that the infection in the middle ear wears down the small ossicles. This can cause fragile ossicles or lead to disruption of the connection between the ossicles, which causes significant hearing loss.  
 
The perforation in the eardrum often occurs because there is prolonged negative pressure in the middle ear and the eardrum is therefore sucked into the middle ear. This makes the eardrum slack and weak and can lead to a perforation developing in the eardrum. Prolonged negative pressure in the middle ear is due to poor function of the Eustachian tube, which is a narrow tube that connects the nasopharynx with the middle ear.  
 
Cholesteatoma (bone decay) is the term for deep pockets of eardrum that have been sucked into the middle ear due to prolonged negative pressure in the middle ear. The eardrum consists of skin, and in the deep pockets shed skin accumulates. This causes chronic infection, which can affect the ossicles in the middle ear and cause significant hearing loss. 

Examination

CPH Privathospital offers outpatient consultation with an ear, nose and throat (ENT) doctor who specialises in ear surgery. A thorough examination of the ears, mouth, throat and nasopharynx is performed; this is done as an endoscopic examination. An examination with a microscope (microscopy) of the eardrum in both ears is also performed, and a hearing test and measurement of the pressure in the ears is carried out.

Treatment 

Hearing can be improved by clearing the infection in the middle ear; by patching a possible perforation in the eardrum; or by re-establishing the connection between the small ossicles if it is disrupted. The latter can be done either by changing the position of one of the three small ossicles (the incus) or by inserting an artificial ossicle (titanium prosthesis). 
 
The operation is performed under general anaesthesia. The ear surgeon uses a microscope and special instruments. The operation can usually be performed through the ear canal, but in some cases it may be necessary to operate behind the ear to gain access to the eardrum and middle ear. If there is a perforation in the eardrum, or if the eardrum needs to be reinforced, this is done with a graft taken from under the skin above the ear or with a little membrane or cartilage taken from under the skin in the ear canal. The operation thus leaves a small scar under the hairline above the ear or in the ear canal. If it has been necessary to operate behind the ear, a scar will form behind the ear. The operation is completed by packing the ear canal with gauze strips that fill the entire ear canal. As a rule, patients can be discharged from the hospital 3-4 hours after the operation.  

Same doctor and rapid treatment

Whether the symptoms have occurred acutely or are of a longer-standing nature, you should be seen by a consultant (specialist doctor) in ear, nose and throat (ENT). Our consultants are ready to help you so that you can quickly receive the correct diagnosis, whether you are a private patient, have health insurance or come through the public waiting time guarantee.

All examinations can take place at CPH Privathospital, and you therefore have the same experienced consultant throughout the entire pathway.