Ear ailments are a common illness. Some cases are cured with medication, while others may need surgery. One of the most common ear ailments is Chronic Suppurative Otitis Media. It is an infection of the middle ear that usually presents with a perforation, causing ear discharge, itching and hearing loss among other symptoms. Depending on the size of the perforation, they may not always heal on their own and may need surgery.
Why do I need a Tympanoplasty Surgery?
Contrary to popular belief, the eardrum not only has a role in a person’s hearing but also acts as a barrier, protecting the ossicles and hearing nerve (auditory nerve) from damage. A damaged eardrum would eventually lead to a further permanent reduction in hearing.
Hence, replacing the damaged eardrum or closing the perforation is critical for the complete recovery from the ailment.
Conventional surgery vs Indorewala Technique
Conventional surgery involves making an incision behind the ear to gain access to the eardrum. It involves drilling into the bone to access the middle ear to place a new graft (tympanic membrane). After this, the wound is packed, closed and sutured back.
While taking longer to heal, this technique is more time-consuming and causes more pain and discomfort to the patient.
On the other hand, the Indorewala Technique of Stitch-less surgery is performed completely through the ear canal. An incision is made within the ear canal and the skin flaps are raised. In the meantime, a deep layer of skin from the thigh (Fascia lata graft) is harvested through a small 8 mm incision. It is then shaped as required and placed in position and skin flaps reposed.
Post-operative Management & Recovery
Patients are kept under observation for up to 24 hours and are allowed to go home. A fresh dressing is applied to the ear before discharge. The patient is called for a follow-up after 10 days.
Patients may return to work the day after surgery, although they are advised against strenuous activities and going to places with loud sounds. The use of earphones is also not recommended. Bathing is allowed, but patients must be careful and not let water enter the ear.
Benefits of the Indorewala Technique
Thorough research along with decades of experience and thousands of surgeries have shown that the Indorewala Technique has the following benefits:
- It has a greatly enhanced success rate and reduces the chances of recurrence due to the lesser shrinkage of the graft.
- Aesthetically pleasing- This surgery is impossible to detect as there are no scars or stitches around the ear.
- Shorter operating time- The Indorewala Technique could take between 20-30 minutes, which is a significant time saving when compared to the conventional technique which takes over an hour and a half. This also means the patient is under anaesthesia for less time.
- Smaller incision: The incision made on the thigh is 8 mm long, as against 50 mm long in the conventional technique which is behind the ear.
- Quicker healing- With smaller incisions, this technique causes significantly less pain and discomfort when compared to the conventional method.
Risks of the Indorewala Technique?
- As with any surgery, there is no 100% guarantee of success. This technique greatly increases the success rate to more than 98%, although there are certain factors that we cannot control.
- A patient could have a localised infection, though this is very rare and is easily treated with medications.
- For cases operated under general anaesthesia, the risks of anaesthesia are present. However, the chances of complications arising from anaesthesia are rare due to modern techniques of anaesthesia and also due to the lesser duration of anaesthesia.