Tympanoplasty (Eardrum Repair Surgery)

Every time water gets into that ear, it starts discharging again. You've had drops, antibiotics, and advice to plug the ear with cotton when you bathe, and the hearing on that side has slowly become duller. A long-standing hole in the eardrum, often left behind by ear infections in childhood, is a common cause.

The eardrum (tympanic membrane) is a thin, skin-like membrane that seals the middle ear and passes sound vibrations to three tiny bones called the ossicles. Tympanoplasty repairs a hole in it. Working under a microscope or through an endoscope, the surgeon places a graft beneath the hole, usually a thin sheet of tissue from the covering of the muscle above your ear (temporalis fascia) or a sliver of cartilage. Over the following weeks, your own eardrum grows across the graft and seals the gap. If the ossicles are damaged, they can be repaired in the same operation.

The graft takes successfully in roughly 85 to 95 out of 100 operations. A sealed eardrum keeps water and germs out, so the discharge usually stops. Hearing often improves too, but not always, and how much depends on the ossicles and the inner ear.

In our ENT department, eardrum perforations that won't heal on their own are repaired with tympanoplasty. Before surgery, we examine the ear under a microscope and test your hearing with pure tone and impedance audiometry, so you know what to expect. If the examination shows cholesteatoma (a skin cyst growing inside the middle ear), a different and larger operation is needed, and we'll explain what it involves.

Most small holes from a recent injury or infection heal by themselves within a couple of months, so surgery isn't done straight away. Tympanoplasty is advised when a perforation hasn't healed after about 3 months, or when damage in the middle ear affects your hearing.

The graft is fragile for the first few weeks, so two rules come first: keep the ear dry, and avoid sudden pressure in it.