Ear Drum Perforation Surgery

What is myringoplasty or tympanoplasty?

If you have perforated eardrum or hole in the eardrum, then your surgeon may recommend ear surgery to close this hole and in some cases to help repair the hearing.

Why do we have eardrum?

The eardrum separates the ear canal from the middle ear. The sound hits the middle ear and is then transferred to the inner ear where the sound is converted to an electrical signal and taken to the brain to interpret. Our eardrum is very similar to speakers with the magnet in the centre and paper around the magnet. If there is tear in the paper, the sound dampens down. So mainly eardrum perforation can lead to an ear infection as now bacteria can reach easily into the middle ear and hearing loss as now the sound transmission is interrupted.

Why do I have a hole in my ear drum?

Hole in the eardrum can be due to trauma due to earbud injury or barotrauma while landing on an aeroplane. If someone has grommet or ventilation tube inserted, this can leave you with the perforated drum as well. In some cases, when infection builds up behind the drum, it can result in eardrum perforation.

What can be done for perforated eardrum or hole in eardrum?

Good news is in most cases with small perforation the hole can close on its own in 6 to 8 weeks. If the hole is large, then a visit to ENT surgeon can help you decide if you wish to have surgery to close the hole or wish to keep the ear dry and wait and watch. Hearing loss can be improved with hearing aid.

What are the complications of not having eardrum surgery?

If you decide not to have surgery, then you may continue to have ear infections. In some cases, recurrent ear infections can damage small bones of hearing, adding to hearing loss. In some cases, skin from the ear canal can migrate to the middle ear to form cholesteatoma. In rare cases, ear infections can spread to the bone or to the brain to cause meningitis (1 in 10,000).

What approaches can be used to repair eardrum?

There is a significant advancement in surgery of eardrum. The eardrum can be repaired using an endoscope (specialized camera) through the ear canal. Traditionally eardrum repair has been done using cut on the skin behind the ear or in the front of the ear.

What are the main advantages of endoscopic ear surgery?

Endoscopic ear surgery is minimally invasive, with quick recovery. Endoscopic ear surgery allows gentle tissue handling and less pain.

What are the complications of perforated eardrum surgery?

It is very important to discuss with the surgeon his own results. You should go through all complications in detail so that you can make an informed shared decision to have ear surgery.

As with every surgery, there are potential complications, though very rare. It is our duty to discuss all possible complications with you.

There is a potential risk of hearing being worse after the procedure and a very rare risk of total hearing loss altogether. Depending on the type of operation there may be a chance of improving the hearing on the second stage.

Dizziness may occur after the procedure but rarely last after one week and gradually resolve.

Tinnitus may persist or appear after the procedure, which may be totally unrelated to the operation performed.

Change in taste could appear after surgery due to stretching of taste nerve or sacrificing nerve if involved in infection to achieve dry ear. This may improve up to one year.

Numbness of the ear, this improves after a couple of months.

Facial weakness is a potential complication of ear surgery. We use nerve monitoring during the procedure. It can appear after a few days and can be temporary or permanent.

Allergic reaction to packing material can happen and lead to pain and swelling around the ear. Please let us know if you are allergic to iodine.

CSF is fluid around the brain. CSF leak can happen during the procedure due to infection eroding the bone or during drilling. If it happens we repair it and advice given. This can cause a risk of meningitis/ brain infection.

Anaesthetic complications will be discussed by the anaesthetist. Do inform the team all the medications you are taking, including blood thinners and herbal tablets.

Follow up

All patients are followed up after 2-3 weeks after the procedure. If you need a sick certificate, please ask the nurse for it.

CONTACT ENT TEAM OR COME TO ACCIDENT EMERGENCY IF YOU
- Have temperature
- Headaches not responding to regular painkillers
- Dizziness getting worse.
- Facial weakness

When can I do my other activities after ear surgery?

You should be able to go home the same day after surgery. You should keep the ear dry for 6-8 weeks. Smoking can affect the normal healing of eardrum. So you should avoid smoking while eardrum is healing. You should not drive for 48 hours after surgery or till dizziness goes away. You should be able to start your regular exercise after 2 weeks. Do not wet your ear till eardrum has healed well. You should use vaseline with a cotton ball with an ear cap while washing your hair. You can start swimming when your surgeon advises you.

What outcome should I expect after ear surgery?

8 out of 10 eardrum heal without any complications. Healing and closure of hole depend on patient factors (your healing, extent of the infection, your eustachian tube function, smoking) and surgeon factor (the technique used and most importantly the experience of the surgeon).

Mr Gaurav Kumar

Consultant Ear Nose Throat Surgeon

To Book Appointment

Book online

Email info@entsurgeonclinic.co.uk

Call Us On 07494914140

Disclaimer: For general information only, always seek medical advice from your treating consultant.

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ENT conditions (Mr Gaurav Kumar)

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