The word "tympanoplasty" makes me think of drums and plastic surgery, and rightly so since it is a surgical procedure to reconstruct the ear drum (or the "tympanic membrane", in medical speak). It is done to repair a perforation (a tear, rupture, hole, etc) in the ear drum, and Ella is having this surgery because one of her tubes left a hole behind that never closed on its own. From what I understand, this is not terribly uncommon, but it is definitely not what usually happens when tubes come out.
Ella had her tubes put in at 21 months. They came out of the ear drums around the time she turned three, and were actually out of her ears and saved in a Ziploc bag in her keep box by the time she was four. It was while they were resting in the ear canals that the pediatrician started watching her perforation to see if it would close. He also sent us to the ENT so he could watch it. When the ENT saw no change at all, he decided we should fix it as she approached her fifth birthday. As God would have it, after almost two years without an ear infection, she got strep throat and a really nasty upper respiratory infection. The ear without the perforation was infected, but the ear with the hole in it was not because the hole was still acting like a tube and ventilating the ear so it could drain. Surgery was postponed.
Armed with that knowledge, a teeny bottle of ear drops that cost $120, and a pack of ear plugs, we made it through the summer with only one mishap when the ear plug came out in the pool. The magical ear drops cleared up that infection and we saw the ENT last fall for a hearing test and made plans to schedule surgery in the spring. She has some very minor hearing loss of lower frequency sounds in the "bad" ear (i.e. she can't hear me when I speak quietly in a low voice, but she can hear me from three rooms away when I'm just having a semi-private conversation with Dave in the kitchen). We followed up with the ENT in January, and since we survived this cold and flu season without a new ear infection, surgery to repair the hole is a go.
It is an outpatient procedure that takes a couple of hours. Basically, they will make an incision behind her ear to get a piece of tissue that they will then use to patch the ear drum. The ENT says the hole makes up about 30% of her ear drum, and he had actually done a surgery to repair a hole almost identical to hers on the day we saw him. He did a fantastic job of explaining the procedure so that Ella could understand. Once the patch is in place, they will pack the ear with dissolvable material to support it while it heals. After five days, we'll use ear drops (that probably cost a fortune) to facilitate healing, and we'll follow up with the ENT in three weeks. She can't play soccer or participate in PE or recess until the three week follow up, but I purposely scheduled it during the school year/soccer season so that it will be healed in time for swimming so she can go without the blasted ear plug this summer.
Several months from now, they'll do another hearing test to see if her hearing has improved in that ear, and they expect it to be normal since what loss she has is caused by the holey ear drum. How they figure all that stuff out from a hearing test is amazing to me.
We've talked about the surgery quite a bit over the last couple of weeks and her concerns are exactly what the Children's Hospital website told me they would be, plus she's mad that she'll have to fast before surgery. I'm planning to let her fuss and nag about needing food and drink as a method to distract her from being scared. We should cater to their strengths, right?
On a very positive note, since she is 5, she was not subjected to the Hearing Test of Terror that poor Luke had to survive two years ago. Thanks goodness; we wouldn't have slept for weeks if that had happened to her.
P.S. If you are a nerd like me and want to see pictures and diagrams, this is a good link that explains the procedure. Tympanoplasty
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