What are the complications of surgical repair of tympanic membrane perforation (TMP)?

Updated: Dec 14, 2020
  • Author: Robert A Saadi, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Each operation carries a risk of exacerbating hearing loss. Exact incidence of such hearing loss is unclear, with reported rates varying widely in the medical literature. In one series, approximately 1 per 500 operations resulted in much worse hearing. In another, the rate was nearly 2% for some degree of loss. Of 1000 patients, expect one to experience a perforation and four to endure lost hearing. In a small group of patients, persistent eustachian tube dysfunction leads to late complications, such as cholesteatoma, reperforation, or middle ear effusion. When the underlay technique of tympanoplasty is used, incidence of intratympanic cholesteatoma is less than 1%. [24]

Overlay tympanoplasty is more technically challenging, requiring stripping of the epithelial layer of the tympanic membrane, and is associated with the risk of lateralization of the tympanic membrane and blunting of the anterior angle (with the possible ensual of conductive hearing loss). However, this technique does have very high success rates for closure of perforations with both endoscopic and microscopic visualization techniques. [34]


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