CPT® Code 69633

Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [PORP], total ossicular replacement prosthesis [TORP])

A tympanoplasty without mastoidectomy is a surgical procedure aimed at repairing the tympanic membrane (eardrum) and, in some cases, reconstructing the ossicular chain, which consists of the small bones in the middle ear. This procedure can be performed as an initial surgery or as a revision of a previous tympanoplasty. It may involve additional techniques such as canalplasty, which is the widening of the ear canal, atticotomy, which is the surgical opening of the tympanic attic, and/or other middle ear surgeries. The classification of tympanoplasties is based on whether the surgery focuses solely on repairing the tympanic membrane or if it also addresses the ossicles. In contrast to CPT® Code 69631, which involves tympanoplasty without ossicular chain reconstruction, CPT® Code 69633 specifically includes the reconstruction of the ossicular chain using a synthetic prosthesis, such as a partial ossicular replacement prosthesis (PORP) or a total ossicular replacement prosthesis (TORP). The procedure can be accessed through the ear canal or via a post-auricular incision, depending on the specific needs of the patient. If the external auditory canal is narrowed due to recurrent infections, a canalplasty is performed to enhance access. The surgical process includes inspecting the tympanic membrane and middle ear structures, removing any scar tissue, and preparing a graft to cover the tympanic membrane defect. The use of absorbable materials helps support the graft during the healing process, ensuring optimal recovery and restoration of hearing function.