Ear drum repair (tympanoplasty)
鼓膜修复术（鼓膜成形术）

What is the tympanic membrane?
什么是鼓膜？

The ‘tympanic membrane’ is the eardrum. It is a partition between the external ear canal and the middle ear. The middle ear is an air-filled space containing three important ear bones. Sound reaching the ear drum vibrates the ear bones and transfers the energy towards the inner ear.
“鼓膜”是耳膜。它是外耳道与中耳之间的隔膜。中耳是一个充满空气的腔室，含有三块重要的听小骨。到达鼓膜的声音使听小骨振动，并将能量传向内耳。

The ear drum protects the structures in the middle ear by providing a water-proof barrier to the outer world.
鼓膜通过为外界提供防水屏障来保护中耳内的结构。

What causes a perforation (hole in the eardrum)?
鼓膜穿孔（鼓膜上的孔）是什么原因引起的？

The commonest cause of a perforation is infection. After an ear infection results in a perforation, the ear drum usually heals on its own. Occasionally, a hole is left behind that can only be fixed by surgery.
鼓膜穿孔最常见的原因是感染。耳部感染导致鼓膜穿孔后，鼓膜通常会自行愈合。偶尔会留下仅能通过手术修复的孔洞。

Trauma is another cause of perforations, but these almost always heal on their own.
外伤也是鼓膜穿孔的原因之一，但这些几乎总能自行愈合。

What problems can my child have with a perforation?
孩子有鼓膜穿孔会出现哪些问题？

Recurrent infections  复发性感染

Infections occur as the perforation is a direct link to the outside world, allowing substances to enter the middle ear along with water and lead to infections.
由于穿孔直接连通外界，物质和水可进入中耳并导致感染，因此会发生感染。

Hearing loss  听力下降

A perforation can reduce the transfer of sound energy to the inner ear resulting in a hearing loss. This is usually mild. Hearing loss that is more pronounced may indicate a problem with the bones of hearing.
鼓膜穿孔会减少声音能量向内耳的传递，导致听力下降。这通常为轻度。更明显的听力下降可能提示听骨存在问题。

What is a tympanoplasty?
什么是鼓室成形术？

A tympanoplasty is a surgical procedure that repairs or reconstructs the eardrum (tympanic membrane) to help restore normal hearing. This procedure may also involve repair or reconstruction of the small bones behind the eardrum. Both the eardrum and middle ear bones need to function well together for normal hearing to occur.
鼓室成形术是一种外科手术，用于修复或重建鼓膜（鼓膜）以帮助恢复正常听力。该手术也可能涉及修复或重建鼓膜后方的小听骨。鼓膜与中耳听骨需要协同良好才能实现正常听力。

Why does my child need a tympanoplasty?
为什么我的孩子需要鼓室成形术？

A tympanoplasty is recommended when the eardrum is torn (perforated) or sunken in (retracted), which may be associated with hearing loss.
当鼓膜破裂（穿孔）或内陷（回缩），并可能伴有听力下降时，通常建议进行鼓室成形术。

Surgery is usually suggested if a child with a perforated eardrum is having recurrent infections, or if they wish to have a waterproof ear for swimming. Hearing loss alone is usually not a reason for considering surgery, as hearing improvement with surgery may be variable.
如果孩子鼓膜穿孔伴有反复感染，或希望耳朵防水以便游泳，通常会建议手术。单纯听力下降通常不足以作为考虑手术的理由，因为手术后的听力改善可能存在差异。

This operation can be performed whenever your child is ready to have it done. Although in cases where there is a significant infection then this operation may be necessary to prevent more significant damage to the ear and the surgery may need to be performed more urgently.
只要您的孩子准备好了，就可以进行此手术。但在存在严重感染的情况下，为防止对耳朵造成更严重的损害，可能需要更紧急地进行此手术。

Is there an alternative to the operation?
有没有手术替代方案？

It is not always essential to undergo surgery, especially if your child is not having problems with recurrent infections. If surgery is not performed, you can help to reduce the risk of repeating ear infections by keeping the affected ear dry. This can be done using ear plugs when washing your child’s hair, during bathing, swimming or showering. For swimming, the use of a swimming cap or ear protectors in addition to ear plugs is useful. Custom made swimmer’s moulds can be obtained from our audiology team to reduce the chances of water getting in the ear.
并非在所有情况下都必须接受手术，尤其是当您的孩子没有反复感染问题时。如果不进行手术，您可以通过保持受影响的耳朵干燥来降低反复耳部感染的风险。洗头、洗澡、游泳或淋浴时可使用耳塞保护耳朵。游泳时，除了耳塞外使用游泳帽或耳部防护器也很有用。我们的听力学团队可提供定制的游泳者耳模，以减少水进入耳朵的可能性。

Your surgeon may also suggest the use of hearing aids if your child’s hearing test has shown a reduced in their hearing, and our time can provide a copy of your child’s hearing test to document any hearing deficiency.
如果孩子的听力测试显示听力下降，您的外科医生也可能建议使用助听器，我们的团队可以提供孩子听力测试的复印件以记录任何听力缺陷。

How successful is tympanoplasty?
鼓膜成形术的成功率如何？

We are able to create a waterproof ear is obtained in around 9 out of 10 cases, with 9.5 to 10 people having a reduction in infections. Roughly 7 out of 10 patients will have an improvement in hearing.
大约有 9 成病例可以获得防水的耳道，9.5 到 10 人会有感染减少。大约 7 成患者的听力会有所改善。

Risks of tympanoplasty surgery
鼓膜成形术的风险

Hearing loss  听力丧失

The primary aim of a tympanoplasty is repair of the ear drum to avoid ear infections; hearing improvement is usually a secondary goal and may not always be achievable. Some hearing loss (more common if small bones have been repaired) may still be present after the procedure.
鼓室成形术的主要目的是修复鼓膜以预防耳部感染；听力改善通常是次要目标，且不一定总能实现。手术后仍可能存在一定程度的听力损失（如果修复了听小骨则更常见）。

There is a very small chance of losing the hearing completely and this would have been discussed with you before you consent for your child to undergo this procedure.
有极小的可能性完全失聪，这一点会在您为孩子签署手术同意书前与您讨论。

Dizziness  头晕

Your child may be slightly off balance and this is often due to the packing used after the operation. This usually settles down.
您的孩子可能会有轻微的平衡不稳，通常是由于术后所用填塞物所致。此情况一般会自行缓解。

Persistent dizziness and imbalance after surgery is rare, although more common if the small bones have been repaired.
手术后持续的头晕和平衡障碍很少见，但如果修复了听小骨则更常见。

Tinnitus  耳鸣

After surgery, tinnitus and other strange sounds are common while the packing material is in place. This usually settles down.
术后在填塞材料仍在耳内时，耳鸣和其他异常声音很常见。通常这些症状会逐渐消失。

If your child has tinnitus before surgery it may remain the same after the procedure.
如果您的孩子在手术前已有耳鸣，手术后耳鸣可能保持不变。

Graft failure  移植物失效

Because this operation involves grafting using your child’s own tissue, very rarely this tissue will not survive long enough for the hole in the eardrum to heal completely. In this case, another operation may be necessary. Because the success rate of this surgery is around 80 percent, re-operation also has a very high success rate.
由于该手术涉及使用您孩子自身组织进行移植，极少数情况下这些组织可能无法存活足够长的时间以使鼓膜穿孔完全愈合。在这种情况下，可能需要再次手术。因为该手术的成功率约为 80%，再次手术的成功率也很高。

Taste disturbance  味觉异常

The nerve for taste passes just underneath the ear drum, and may be manipulated during surgery. This may lead to a transient change in taste that is often described as a “metallic taste” and very rarely persists beyond 3 months.
负责味觉的神经位于鼓膜正下方，手术过程中可能会受到牵拉。这可能导致短暂的味觉改变，常被描述为“金属味”，极少在 3 个月后仍持续存在。

Transient facial nerve weakness
短暂面神经无力

A large nerve that supplies the muscles of the face runs through the middle ear. Rarely, there can be transient weakness of the face due to the anaesthetic medicines applied to the ear.
面部肌肉的供神经有一条大神经穿过中耳。极少数情况下，施用于耳部的麻醉药物可能会导致短暂的面部无力。

What time will my child have their operation?
我孩子的手术会在什么时候进行？

You will be informed whether your child’s operation is in the morning or afternoon when you are contacted by the hospital to confirm a date for surgery.
当医院联系您确认手术日期时，会告知您孩子的手术是在上午还是下午。

What time should I bring my child to the ward?
我应在什么时候把孩子送到病房？

You will receive a letter telling you the date of your child’s operation and the time you need to bring them into hospital.
您将收到一封信，告知您孩子手术的日期以及需要将他们送到医院的时间。

Usually, if your child’s operation is in the morning you will be asked to arrive on the admission ward at 7.45am, and if your child’s operation is in the afternoon you will be asked to arrive on the admission ward at 11am or 12pm (midday).
通常，如果您孩子的手术在上午，您会被要求在上午 7:45 到达入院病房；如果手术在下午，则会被要求在上午 11:00 或中午 12:00 到达入院病房。

What shall I do if my child has a sore throat, a temperature or is unwell a few days before or the day of their operation?
如果在手术前几天或手术当天，孩子喉咙痛、发烧或身体不适，我该怎么办？

You need to telephone the hospital on 0114 271 7286 and tell us. You will then be told whether it would be safe for your child to have their operation as planned.

On the day of the operation

What time should I give my child their last food and drink?

If your child’s operation is in the morning they can eat and drink until 2.30am, and then have clear fluids (water, diluted squash and fruit juice without pulp) until arrival on the ward. Please note they should not have chewing gum or boiled sweets either.

If your child’s operation is in the afternoon they must have finished their breakfast by 7.30am, and then have clear fluids (water, diluted squash and fruit juice without pulp) until arrival on the ward.

What will happen when we arrive on the ward?

An anaesthetist will visit your child and make sure they are fit for their operation. They may prescribe some anaesthetic cream for your child’s hand so that it does not hurt when a tiny tube is inserted into their hand to let the anaesthetic to be given. This tube is inserted when your child is in the anaesthetic room.

The surgeon will also see you and your child before their operation.

A nurse will take your child’s temperature, weigh them and put a name band on their wrist. Your child will be asked to put on a theatre gown or their pyjamas. If your child has long hair they will need to tie it up in a ponytail with a non-metallic band. All jewellery and nail varnish must be removed. The nurse will then apply the magic cream to their hands.

Your child will either walk or be taken to theatre on a trolley. 1 parent or carer may go to the anaesthetic room and stay with them until they are asleep.

How long will the operation take?

Your child will be away from the ward for about 2 to 3 hours altogether.

What happens during the tympanoplasty?

The surgery is done under general anaesthetic.

The surgeon makes a small cut either behind or in front of your child’s ear and the eardrum is then carefully exposed. Alternatively, this may be performed without any external cuts with a telescope directly through the ear canal. A piece of tissue called a graft is then placed underneath or within the eardrum to act as a scaffold for the eardrum to grow on.

Usually, the surgeon will use skin or cartilage from your child’s body from either behind or in front of the ear.

Alternatively, an artificial or animal graft may be used. If this is the case, the surgeon would discuss this with you when planning the operation.

Careful steps are taken to preserve hearing and not to damage the facial nerve. If needed, reconstruction of the middle ear bones may also be performed at this time.

The surgeon may pack the ear canal with a material to keep the repair in position and reduce the chances of infection. Depending on the approach, a head bandage may be used, which is removed the next day.

Will my child have any stitches?

Yes, but these usually dissolve after a few weeks. If they need to be removed this can be done at your GP practice 5 to 7 days after the operation.

After the operation

Will I be there when my child wakes up?

The escort who takes you and your child to the anaesthetic room will tell you how you will be contacted so that you can be with your child.

Will my child have any pain?

Your child will have been given some strong painkillers in theatre before they wake up.

They may have some pain later but the nurse will give them some medication to ease this.

When can my child have something to eat or drink?

Your child can have their first drink as soon as they wake up after the operation. Once they have had a drink the nurse will tell you when they can have something to eat. This is usually a slice of toast or a biscuit.

When can my child go home?

This depends upon the opinion of your child’s surgeon and also how quickly your child recovers from their operation. Your child may be able to go home the same day or may stay in hospital for 1 night.

How do I look after my child at home?

You will be given painkillers which you should give regularly to your child for the first 3 days and then gradually reduce the amount you give as your child’s pain reduces.

A small amount of discharge from the ear is normal.

You must keep your child’s ear dry.

If the packing material starts to fall out don’t worry, as the surgeon has usually put more than one piece in.

Do not attempt to push the pack back in; if it is hanging from the ear canal cut it off carefully using a pair of scissors.

When can my child go back to school?

We usually suggest that your child has 2 to 3 weeks off from school, to avoid infections and allow the ear to heal.

Will my child be able to hear after the operation?

Your child will not be able to hear very well whilst the packing is in their ear.

Will I need to see the ENT doctor again?

Yes. You will receive an appointment either to be seen in the outpatients clinic a few weeks after your child’s operation or an appointment to be admitted to the Day Care ward for your child to have packing removed under a short general anaesthetic.