Surgical repair of an eardrum perforation and, when needed, of the ossicular chain in the middle ear. Performed for recurrent ear discharge and conductive hearing loss.
Indication
- Persistent eardrum perforation (not healing spontaneously within 3-6 months)
- Recurrent ear discharge and chronic middle-ear infection (chronic otitis media)
- Conductive hearing loss caused by perforation or ossicular-chain damage
- Need to reduce the risk of infection from water exposure (swimmers, divers)
- Cases requiring eardrum repair together with cholesteatoma (planned with tympanomastoidectomy)
- Non-healing eardrum tears caused by trauma or a foreign body
Preparation
- No food or drink for 6-8 hours before the surgery
- If there is active ear discharge, ear drops are used to achieve a dry ear before surgery
- Audiometry (hearing test) is performed and a temporal-bone CT scan is obtained when indicated
- Blood thinners are stopped with physician approval; allergies and prior anesthesia history are shared
- Stopping smoking at least 2 weeks before surgery supports graft survival
How it's performed
- General or, rarely, local anesthesia is used
- Surgical access is gained through behind the ear, through the ear canal, or with an endoscopic approach
- Graft material (temporal-fascia or cartilage) is harvested from the patient
- The edges of the perforation are freshened; the middle ear and ossicular chain are evaluated
- The graft is placed beneath or over the eardrum to close the perforation; ossicular-chain repair (ossiculoplasty) is added when needed
- A dissolvable or removable pack is placed in the external ear canal; the surgery lasts 1-2 hours
Post-procedure
- Discharge usually on the same day or after one night
- No water in the ear and limited nose-blowing for the first 2-4 weeks
- Ear drops, oral antibiotics, and pain relievers are used as the physician advises
- Pack inspection and cleaning of the external ear canal between weeks 1-3
- Follow-up audiometry at 2-3 months to assess graft take and hearing
Risks
- Graft failure with re-opening of the perforation
- Temporary or permanent hearing loss (especially after ossicular-chain surgery)
- Taste disturbance (involvement of the chorda tympani nerve, usually temporary)
- Dizziness, tinnitus, and temporary balance issues
- Very rare facial-nerve involvement and infection
FAQ
Will my hearing improve right after tympanoplasty?
Hearing may not be clear for the first 4-6 weeks because of the pack and swelling inside the ear. Once the graft heals and the middle ear refills with air, hearing improves gradually.
When can I fly after the operation?
Air travel is generally not recommended for 4-6 weeks, since pressure changes can adversely affect graft healing. Your physician will determine the timing based on your individual situation.
Does the graft always take?
Success rates with modern techniques are high; however, smoking, infection, and Eustachian-tube dysfunction can reduce success. If the graft fails, additional surgery may be needed.
Will I be able to swim or go in the sea?
No water should enter the ear during the early weeks. Generally after 6-8 weeks, with physician approval and using earplugs when needed, swimming is possible.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
Mastoidectomy
Otorhinolaryngology (ENT)
Mastoidectomy — surgical clearance of the mastoid bone for chronic middle ear inflammation and cholesteatoma.
Tympanometry
Otorhinolaryngology (ENT)
Tympanometry (middle-ear pressure test) — objective evaluation of eardrum mobility and middle-ear function.
Otoscopy
Otorhinolaryngology (ENT)
Otoscopic examination — basic ENT assessment in which the external auditory canal and eardrum are evaluated with an illuminated magnifier.
Audiometry
Otorhinolaryngology (ENT)
Audiometry (hearing test) — objective evaluation of the type and degree of hearing.
Adenoidectomy
Otorhinolaryngology (ENT)
Adenoidectomy (adenoid removal surgery) — removal of enlarged adenoid tissue to restore nasal breathing and middle-ear comfort.
Ventilation Tube
Otorhinolaryngology (ENT)
Ventilation tube (myringotomy with tube) — placement of a small tube into the eardrum to drain middle-ear fluid and restore aeration.
Epley Maneuver
Otorhinolaryngology (ENT)
Epley maneuver — repositioning of inner-ear crystals in benign paroxysmal positional vertigo (BPPV).
EARWAX REMOVAL
Otorhinolaryngology (ENT)
Cerumen removal — safe extraction of earwax obstructing the ear canal using drops, irrigation or curette.