How does the surgery work?
In itself, the insertion of a tympanic tube is not a real operation, but rather an outpatient procedure. It only takes a few minutes and usually does not require any further hospitalization. However, the procedure itself injures the eardrum, so that information about the course of the procedure and the possible risks is necessary.
This is what gives this minor procedure its surgical character. In order to make the use of the tympanic tube as comfortable as possible for the affected person, an anesthetic of the eardrum is necessary. This can be done locally by applying an anesthetic to the eardrum in the form of a solution or by administering an analgesic in the form of an infusion.
If the patient chooses local anesthesia, he or she will be awake during the entire procedure and can, in principle, go home immediately afterwards or continue treatment. If general anesthesia is considered, this is usually due to the planned further treatment of the middle ear during the procedure. If flushing or further rehabilitation of the middle ear is necessary, general anesthesia is necessary for a short period of time.
In children, fear or excitement play an important role in the decision to use general anesthesia. Once the eardrum is anaesthetized, it is opened by a scalpel in the anterior lower quadrant with a small slit. The tympanic tube is then inserted into this slit.
It does not require any further fixation, as the injury to the eardrum causes it to stick to the little blood released, thus providing a natural hold. Once the tube has been inserted, the procedure is finished and the patient needs to be observed for a short time. After general anesthesia, a short inpatient stay should be considered in each individual case.
The follow-up treatment requires further therapy of the triggering cause. In most cases, inflammation of the middle ear has been the indication for a tympanic tube. Adequate therapy with antipyretic drugs, painkillers and antibiotics is therefore an important part of the follow-up treatment in addition to regular checks on the position of the tympanic tube.
In acute cases of illness, this means that the physician has to call in the affected person at intervals of a few days in order to adjust the medication if necessary and to guarantee the drainage of the secretion through the tympani tube.Once the disease is overcome, the tympanic tube is left in place in most cases. It is rejected by the body itself and guarantees a completed healing process. When the eardrum is replaced in the injured area, the tube is pushed forward bit by bit towards the external auditory canal.
As the tissue defect is covered, it falls into the external auditory canal and is often lost unconsciously due to its small size. The restored eardrum thus speaks for a healed process, since it can only grow together completely in the absence of pathogens or secretions. On the other hand, there would be too much tension on the eardrum due to accumulated fluid, so that its wound edges could not close up.
Therefore, one waits a few weeks for the natural healing process. A follow-up check at a generous distance is therefore justified after the acute treatment by a general practitioner. It depends entirely on the degree of the illness how long the tympanic tube must remain in the eardrum.
In the case of an acute illness, it should be left in place until complete healing is achieved. If chronic symptoms are present, it may also be necessary to remain in the eardrum for up to twelve months. If it is inserted due to an acute inflammation of the middle ear, it is usually rejected by the body itself within a few days to a maximum of two weeks.
During this time, those affected also still suffer from a feeling of illness, so that the tympani tube still has a right to remain even if there is a clear improvement and further supports further healing. In most cases, the body itself removes the tube. In the course of the natural healing process it is pushed by new tissue towards the external auditory canal.
Figuratively, this can be explained by its natural shape. It resembles a funnel, with the narrowing pointing towards the middle ear. The tympani tube is located in the lower front quadrant and thus has its main weight by means of gravity in the direction of the external auditory canal.
If the defect in the eardrum is closed and the material of the tympanic tube, which is recognized as foreign to the body, is rejected, it falls outwards and not in the direction of the middle ear. If this process does not occur, the tube can also be removed manually by the physician. This is especially the case with T-shaped timpani tubes as part of a long-term therapy.
By pulling on the tube, the carriers behind the eardrum fold up and the tube can be removed without any problems. The length of time a tube is used is determined by its shape and the choice of material. A long dwell time is guaranteed by a T-shape.
The roof of the T ́s lies behind the eardrum and prevents the material from being rejected by the healing process. The choice of silicone as a material also promises good compatibility so that the eardrum is affected as little as possible by the foreign body introduced. If these factors ensure an optimal fit and good tissue compatibility, a tympanic tube can remain for up to a year or more. However, the permeability of the tube should be checked regularly.
