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Options for ruptured eardrum with eustachian dysfunction
mhhdavis posted:
My 18-year old daughter has had 5 tympanoplasties to repair a ruptured eardrum. The most recent surgery was 18 months ago. Six months after the tympanoplasty and mastoidectomy, the eardrum ruptured again. Surgeon has decided her eustachian tube is dysfunctional and it isn't worth repairing the eardrum again. I don't necessarily disagree.

However, she is a musician and she feels that her hearing (or lack thereof) in one ear is keeping her from reaching her full potential. Also, being in a large group of people is confusing to her due to her hearing issues.

She had her first ear infection at age 2 weeks. She has had fewer infections with holes in her eardrums than at any other time. She has done the ear tube thing (which is what caused the original hole). Her tonsils and adenoids have been removed.

Are there any options left for her? Her ear surgeon said not to bother with a hearing aid that having diminished hearing in one ear would be better than dealing with the issues hearing aids bring.

She has ear pain without infection and feels that her eardrum is disintegrating (it isn't) but she feels that her hearing is getting worse.

She has been researching options that allow for opening up the eustachian tube but, to the best of my knowledge, this is still considered experimental.

Is there any where to turn from here? Any suggestions?
Rod Moser, PA, PhD responded:
There are many different ways to do a tympanoplasty. Do you know if her ENT was doing the same method each time? Have you considered arranging a "second opinion" with another ENT or otologist? Sometimes, taking her case to the highest level - like a university-based medical center ENT department -- is the way to go (assuming you are not doing this already).
mhhdavis replied to Rod Moser, PA, PhD's response:
Her tympanoplasties have been done at least 3 different ways by two different surgeons. The one time her eardrum seemed ready to maintain itself, she developed a cholesteatoma behind it and it had to be removed. Her last surgery was done by a partner in the same practice (her first surgeon recommended that she have someone different look at it) who does practice at a University medical center. I feel that both her surgeons were excellent; in my opinion neither of them mishandled her case.

She is frustrated and would like to have a functioning eardrum. I'm thinking that at this point in time, that will not be an option.

She has been researching a procedure called "Eustachian Tube Dilation." Her last surgeon told her that long term results are not yet known and he doesn't recommend it, at this time.
Are you familiar with this? Is it a reasonable surgery or not? I would assume she would still need to undergo a tympanoplasty if they opened her Eustachian Tube.

If anyone is familiar with this surgery, I would appreciate hearing from you.
Rod Moser, PA, PhD replied to mhhdavis's response:
Surgeons have been trying to find a way to Roto-Rooter those tiny Eustachian tubes for years, but so far, those efforts have not been successful to my knowledge. A closed/clogged Eustachian tube is an issue, but if you do something to make the tube OPEN all of the time, this becomes a different issue (Patulous Eustachian Tube). Both conditions are annoying and can be problematic.

Yes, even if your daughter's dysunction e-tube was restored to perfect order (not very likely, unfortunately), that does not change the chronic eardrum rupture that may need repaired. Tympanoplasties are frustating for everyone, since many do not take...even after multiple attempts and various techniques. People often need to adapt to this "extra" opening since it may not be be able to be permanently fixed sometimes.
LizPrice replied to Rod Moser, PA, PhD's response:
I too had 4 tubes replaced, adnoids done, tonsils done, and remain with hearing loss. it started when i was 16, now 20. 20 days ago i had new longer tubes put in.. JUST 2 days ago i came down with a flu or cold and my ear hs been hurting. 2x's i jumped due to pain from my ear and popping. tonight i woke up crying because my ear hurts and is leaking GREEN pus!! what can i do?!?!

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