CPT® Code 69644

Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction

A tympanoplasty with mastoidectomy is a surgical procedure that combines the repair of the tympanic membrane (eardrum) with the removal of infected or diseased mastoid bone. This procedure is performed when there is a need to address issues within the middle ear and mastoid area, particularly when the canal wall is either intact or has been reconstructed. The tympanoplasty aspect focuses on repairing the tympanic membrane, which may involve the reconstruction of the ossicular chain, the series of small bones in the middle ear that are crucial for hearing. The procedure may also include canalplasty, which is the widening of the external auditory canal, especially in cases where the canal has become narrowed due to repeated infections. During the surgery, an incision is typically made behind the ear to access the mastoid bone, allowing the surgeon to inspect the mastoid air cells and determine the extent of the disease. The procedure involves the removal of any infected tissue, debris, and purulent matter from the mastoid air cells. If necessary, the walls of the external auditory canal may be reconstructed after the mastoidectomy. The tympanic membrane is then repaired, which may involve techniques such as rimming the edges of the perforation or using a graft to cover larger holes. The overall goal of this procedure is to restore hearing and prevent future infections by addressing both the tympanic membrane and the underlying structures of the ear.