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tympani nerve injury, usually temporary","Tinnitus or dizziness","Infection or ear discharge","Ear canal narrowing or lateralization of graft","Facial nerve injury (rare)","Anesthesia-related risks","Bleeding or hematoma","Need for revision surgery"],"pain":"Usually mild to moderate ear and graft-harvest-site discomfort for a few days, controlled with oral analgesics; fullness and muffled hearing from packing are common.","preparation":["Otoscopic examination and audiometry","Clear ear infection; ensure a dry ear","Preoperative anesthesia assessment and fasting as instructed","Review of medical history and current medications with surgical team","Keep water out of the ear","Imaging (e.g., CT) only in selected cases"],"recovery_timeline":[{"phase":"First days","description":"Rest at home; ear packing and dressing in place, mild pain, muffled hearing and possible slight drainage.","restrictions":["Keep ear dry","Avoid nose blowing","Sneeze with mouth open","Avoid straining"]},{"phase":"Weeks 1-2","description":"First postoperative review; packing or dressing partly removed at clinic review; most return to light work.","restrictions":["Keep ear dry","Avoid air travel until cleared","Avoid heavy lifting"]},{"phase":"Weeks 3-6","description":"Gradual graft healing and packing dissolution or removal; return to normal activity.","restrictions":["Avoid strenuous exercise until cleared","Avoid swimming until cleared"]},{"phase":"Months 2-3","description":"Graft healing confirmed and hearing retested.","restrictions":[]}],"rehabilitation_days":{"min":7,"max":21,"unit":"days","qualifier":"Ordinary functional recovery for daily activities after uncomplicated primary tympanoplasty; no formal rehabilitation program is usually needed."},"result_longevity":"If the graft heals, the closed eardrum is usually permanent, and hearing gains are generally maintained long term. Late re-perforation, retraction or cholesteatoma is uncommon, but it can occur, so periodic ear checks are advised.","revision_rate_pct":{"min":5,"max":12,"unit":"percent","qualifier":"Patients needing repeat surgery, mainly for residual or recurrent perforation, within about 1–2 years; graft failure is 3–15%."},"scars":"Transcanal approach leaves no visible scar; postauricular or endaural approaches leave a small, usually well-hidden incision behind or at the ear.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation for uncomplicated primary tympanoplasty; staged surgery is reserved for complex cases."},"stages":[{"code":"tympanoplasty_surgery","label":"Tympanoplasty with graft reconstruction of the tympanic membrane","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on day of surgery."}}],"qualifier":"Follow-up checks are routine care, not additional treatment stages."},"success":{"metric":"Graft take rate (intact tympanic membrane)","value":90,"unit":"percent","horizon":"12 months","evidence_status":"limited","population":"Adults and children after primary tympanoplasty or myringoplasty; reported graft take about 82–97%."},"techniques":[{"name":"Underlay (medial) graft tympanoplasty with temporalis fascia or cartilage","suits_whom":"Most common approach for small to large perforations with adequate remnant for support.","recovery":"Similar to standard recovery; packing in the middle ear and healing over weeks."},{"name":"Overlay (lateral) graft tympanoplasty","suits_whom":"Selected anterior or total perforations where the remnant is inadequate.","recovery":"Often somewhat longer epithelial healing."},{"name":"Endoscopic transcanal tympanoplasty","suits_whom":"Selected small to medium perforations with accessible margins.","recovery":"Avoids external incision and may allow quicker comfort."}],"treatment_conditions":["day_case","outpatient"],"treatment_duration_hours":{"min":1,"max":3,"unit":"hours","qualifier":"Operative time for uncomplicated primary tympanoplasty without mastoidectomy."},"initial_assessment_documents":["Recent pure-tone audiogram","Temporal bone CT scan report","Otoscopy or otoendoscopy photos of the eardrum","ENT clinic notes on ear discharge history","Prior ear surgery operative reports"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay about 2-4 weeks until the postoperative ENT check clears air travel. Later reviews are done locally."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C2","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C3","text":"Check that the surgeon who consults with you is the same person who will carry out the procedure","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Check that the surgeon you consult with, will be the same person carrying out the procedure.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C4","text":"Ask whether a doctor is always present in the clinic and whether a high dependency or intensive care unit exists","scope":"treatment_abroad","source":{"url":"https://www.bapras.org.uk/public/patient-information/cosmetic-surgery/cosmetic-surgery-abroad","host":"bapras.org.uk","quote":"Is there always a doctor in the clinic and is there a high dependency or intensive care unit?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Ask whether the surgeon and the facility use a surgical safety checklist, which can reduce complications","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Do the surgeon and his/her facility use a safety checklist?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably 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position the tissue under your entire eardrum or just the hole.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"overlay-graft-tympanoplasty","name":"Overlay (lateral) graft tympanoplasty","how_it_works":{"text":"Graft is placed on top of the remaining eardrum ring","source":{"url":"https://www.entnet.org/resource/cpt-for-ent-tympanoplasty-2/","host":"entnet.org","quote":"The surgeon chooses an appropriate technique for placement of the graft under (underlay or medial graft technique) or on top of the remaining annulus (overlay or lateral graft technique).","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"endoscopic-transcanal","name":"Endoscopic transcanal 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