Myringoplasty and Tympanoplasty
Patients may suffer repeated ear infections as a result of a perforation of the eardrum. The perforation may have initially resulted from trauma or a middle-ear infection (otitis media). Small perforations may close spontaneously within 6 months if the ear is kept dry. However moderate sized and large perforations usually will need surgical repair to seal. I would usually wait for at least 6-12 months from the onset of the perforation before considering a surgical repair. If surgery is considered necessary, I will then perform a Myringoplasty/Tympanoplasty. In these procedures the patient usually has a general anaesthetic and I will use a small piece of tissue taken from behind the patient’s ear (which is from the covering tissue from a small muscle) and use it to graft the perforation.
Success of such an operation will depend on a number of factors. These include the size and shape of the ear-canal access to the ear-drum. The narrower the ear-canal, less chance of a successful repair. Also, the size of the perforation of the ear-drum is important. The smaller perforations or holes repair more easily than the larger ones. It may be necessary to repeat the operation for a large perforation, as the first procedure may have reduced the size of the perforation, but not completely sealed it.
Patients with perforations may also have reduced hearing. Simply repairing the eardrum often does not result in restoration of the hearing. It may be possible to use a false bone, or tissue to improve hearing at a second stage procedure, however this will depend on a variety of factors.