CPT® Code 69642

Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction

A tympanoplasty with mastoidectomy is a surgical procedure that involves the repair of the tympanic membrane (eardrum) and the mastoid bone, which is located behind the ear. This procedure is often necessary when there is damage to the tympanic membrane or the surrounding structures due to chronic ear infections, trauma, or other medical conditions. The surgery may include additional procedures such as canalplasty, which is the widening of the ear canal, and middle ear surgery to address any issues within the middle ear. The tympanic membrane repair can vary in complexity, depending on whether only the membrane needs to be fixed or if the ossicular chain, which consists of small bones in the middle ear, also requires reconstruction. During the tympanoplasty with mastoidectomy, an incision is typically made behind the ear to access the mastoid bone. The surgeon inspects the mastoid air cells to assess the extent of any infection or damage. If necessary, a simple mastoidectomy is performed to remove infected tissue and debris. The procedure may also involve the placement of a drain to facilitate healing. If the external auditory canal is narrowed due to repeated infections, a canalplasty is performed to enlarge the canal. The tympanic membrane is carefully inspected, and any scar tissue is removed before the membrane is repaired. Depending on the size and location of any perforations, the repair may involve simply rimming the edges or using a graft. In cases where ossicular chain reconstruction is indicated, the surgeon evaluates the ossicles—specifically the incus, malleus, and stapes—to determine if they need to be reconstructed. Tissue grafts are harvested for this purpose, ensuring that the ossicular chain can function properly to transmit sound. Overall, this procedure aims to restore hearing and prevent further complications associated with ear diseases.