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2nd failed Tympanoplasty - What do I do?

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Old 05-23-2013, 06:02 PM   #1
Join Date: May 2013
Location: Cleveland
Posts: 2
acshaw80 HB User
2nd failed Tympanoplasty - What do I do?

Here's the story:

I've always had eustachian tube dysfunction since I was a child. In my mid 20's I decided to go to a ENT and ask if there was anything thing that could be done as its very annoying to have to constantly be popping my ears. He decided the best option was to put a tube in my right ear which ends up being a terrible mistake because 5 years later a different ENT will tell me I still have the hole in my ear. I was then told that I needed to have it repaired because it would help with the very slight hearing loss I have and also prevent cholesteotomas from developing (which, I was told, can cause facilal paralysis or lead to infections that may cause death). I then meet with a surgeon at the Cleveland Clinic who decided to perform a tympanoplasty using (I believe) muscle tissue to patch my broken ear drum.

I was told after about two months of post surgical doctor visits that graft had failed and that the hole was about 30-40% of my ear drum. I also experienced significant hearing loss in that ear. I would say about a 50% loss which for all intents and purposes still exists today. Its been about two years and I've only recovered a small portion of that initial hearing loss.

I decided to go to another doctor, this time at University Hospitals here in Cleveland. This doctor indicated that he could help fix my hearing while performing a second tympanoplasty. This surgery was performed in November of 2012 and up until today, May 23, 2013 the surgery was considered successful in that the graft had taken (this time cartilage was used for the graft instead of muscle tissue). This surgery improved my hearing by about 5-10%, but I still have that significant hearing loss in my right ear. The doctor informed me in March that the graft looked great and that I could swim and lift weights. I should also push gently on my ear drums to help clear out any fluid that may still be in them which might improve my hearing. I am to do this about 10x per day until I see him for our next appointment in mid June. Today, while doing this exercise I pushed air through my ear drum. I tested it a second time to make sure that I wasn't mistaken and had the same results. It's my belief that pushing on the ear drum in this way may have weakened it and caused the failure.

At any rate, I'm left asking myself what in the heck I am supposed to do? Why would the 2nd tympanoplasty have failed after it looked so promising? Do I continue having tympanoplastys until one actually works? Is there any real fear of a cholesteotoma forming if I don't have my ear repaired? Is there any real good reason why I shouldn't just leave the hole in my ear? Head surgery is not fun and I'm tired of spending the money on surgeries that don't work for me. Any thoughts?

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Old 05-30-2013, 11:32 PM   #2
Join Date: Jan 2013
Posts: 60
JenPlus2 HB User
Re: 2nd failed Tympanoplasty - What do I do?

Wow AC,
You've been through the wringer! I also have suffered with Eustachian tube problems for a long time, well not my entire life, but it seems like a long time to me. I did try a PE tube last year in one ear to see if it would help me and it didn't at all. I know that they help some, but not me. Was your ETD helped at all by the tubes?

As far as your question on whether you should continue to haven these surgeries, I can't answer that because I don't know if its medically ok to have a fairly large opening in the ear drum. Have you asked your why/otologist what their opinion on this is? I would do that first, and if you don't get a clear answer, get another opinion. I'm sort of shocked that the dr who performed your second surgery would tell you to pop your ears. I mean, it's a delicate new little ear drum, why have you start testing its strength already? It brings my mind back to my c-section with my first daughter's birth... The area they just operated on is very vulnerable and weak. It was 10 wks before I was allowed to climb stairs. I feel like that dr did you a bit of a disservice by having you trying to equalize pressure with a new ear drum. Of course, that is my humble opinion. When I do a valsalva (pop my ears) I can feel the air that goes up there literally thump into my ear drum. It's not the gentlest of things. Is is it in any way possible that your body may be rejecting the patching (similar to transplant?) I know that prednisone is often given to calm the body's immune response in cases of transplant, but I'm not sure about your own body tissue.

I really feel like you should re consult your ent about leaving your ear drum open. The only thing I can think of off the top of my head is that obviously your middle ear would be open to the environment and therefore infection. The other reason is that you will still have the hearing loss, but it seems like the tympanoplasty didn't really change things all that much.

I'm sorry that I don't know more about tympanoplasties, I hope my opinions have been of some use to you.


Old 10-08-2013, 10:03 AM   #3
Marie 67
Senior Member
Join Date: Aug 2013
Location: Ohio
Posts: 195
Marie 67 HB User
Re: 2nd failed Tympanoplasty - What do I do?

I'm sorry to hear about your condition. I had a myringotomy three weeks ago for fluid in my ear and the hole in my eardrum is still opened. It hasn't healed yet. I'm concerned about the same thing happening to me. Do the ent's say your hearing loss is due to the hole in your eardrum? What type of tube was used in your ear? The ent that I have been going to said the trick to putting in a tube in an ear is to get the right size. One that is large enough to allow fluid to drain out but small enough not to damage the eardrum so that when the tube comes out the eardrum is healed or just about. Did the opening become larger due to the failed surgeries? Did you hear better from this ear before the 2 failed attempts at repair? I'm in Ohio also. Is this an unlucky state or what? If you want ear problems move to Ohio.

Old 06-20-2014, 08:25 AM   #4
Join Date: Jun 2014
Posts: 1
Clh070206 HB User
Re: 2nd failed Tympanoplasty - What do I do?

So sorry for everyone. My daughter is 5 and will be 6 in a few months. She has had 2 tympanoplasties. First one muscle and the second was a cartilage. We went back for our post-op and still a hone. Very small but still a hole. So 6 weeks ago we did a type of patch. Our ENT said it was similar to Dermabond patch and should work fine. We did not even have to cut behind the ear. The recovery period was much easier. You can imagine what it's like keeping a small child from running, jumping, and bouncing. So we thought GREAT!!!

Just went back this morning for the post-op visit. And we have a hole!!!! We did not see our regular ENT because we thought it would be an easy fix and a quick follow-up. We will go back on 7/1 to see what her ENT says.

I have a few questions. Why wont the eardrum hold the graphs? Do we keep having these surgeries? Her hearing in her left ear has gotten much better. She has also been in speech therapy for 2 years now and will continue when she begins kindergarten. Any comments or thoughts?

Old 10-03-2015, 03:59 PM   #5
Join Date: Oct 2015
Location: Pueblo
Posts: 2
vawver HB User
Re: 2nd failed Tympanoplasty - What do I do?

I've been in the same boat - first Tympanoplasty failed almost immediately in 2012. Had another procedure (with a cholesteatoma removal) in 2013 by a different Otolaryngologist in a different state. The second procedure looked promising. They were trying something new (cartilage). It held for an entire year and then suddenly I started having some familiar pain/sensation in that ear. I visited a third Otolaryngologist who told me that the perforation was back. Oddly enough, the graft was still in place. It was my eardrum that was connected to the graft that gave out. My eardrum was so delicate that it couldn't hold a strong cartilage graft, so the eardrum around the graft gave out and created a different perforation.

That third Otolaryngologist told me that I need to stop seeing basic ENT doctors. He said at this point it was really important that I see what's called a Neurotologist (a provider who specializes in just ears). He referred me to one of the only Neurotologists in my state. I'm having my third surgery in one week. I discussed the plan with this doctor who said that one of the options would be to completely scrape out my entire eardrum and build a brand new one from scratch. He may take a different approach once my ear is opened and they can observe what's going on, but that is an option.

One potential reason why my eardrum has had trouble holding grafts is because it's been weakened by several years of ear infections during my development. I had tubes, etc. It IS important to repair the eardrum because not doing so could cause other complications such as cholesteatomas (as I quickly discovered after my first attempted surgery). Cholesteatomas can cause pain, grow, and destroy the bones within your ear, possibly causing death if developing in to the brainstem. Not developing another cholesteatoma was my main motivation for pursuing a third surgery.

Old 05-10-2016, 02:48 PM   #6
Join Date: May 2016
Posts: 1
tiggypaw HB User
Re: 2nd failed Tympanoplasty - What do I do?

hello all. i realize this is an old post but wanted to know (if an email draws this to your attention) has anyone dealt with putting a tube back into an ear after having a tympanoplasty? my spouse also had this surgery at the cleveland clinic and months later is still dealing with blockage in the ear and we suspect due to his chronic bad eustation tube. thank you.

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