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Myringoplasty/Tympanoplasty

 
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Perforated ear drum
Myringoplasty is an operation carried out to repair a chronic (non-healing) hole in the eardrum.

A hole in the eardrum may lead to repeated ear infections with pain, discharge and hearing loss. If this is the case, surgery is recommended to close the perforation and put and end to these infections.


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Reparied ear drum following Myringoplasty

Aims of the surgery

1) Prevent recurrent ear infections

2) Improve hearing, if there is a conductive hearing loss due to eardrum perforation

3) Enable patients to swim or get ear wet without facing infection as a consequence.



Myringoplasty surgery

The operation is performed under general anaesthesia, and it usually takes about 1-2 hours. It involves taking a layer of scalp “fascia” usually behind ear in the hairline to use as a graft. This graft is then slipped behind the drum to cover the perforation.

There are two approaches to the eardrum. One is the approach to the eardrum through the ear canal “endaural approach”. The second approach is to make an incision “cut” behind the ear and flipping it forward “post-auricular approach”.

This is decided depending on the site and the type of the eardrum perforation, the reason for the surgery and surgeon’s preference.

At the end of the surgery, the ear is packed with special ribbons.

Complications of Myringoplasty

1) Infection- it could potentially cause graft failure and therefore failure to heal the eardrum

2) Bleeding- very unlikely, however small bloodstained discharged can be expected within the first couple of days after the surgery

3) Graft failure- graft success can be as high as 80%. However the success rate varies depending on many factors such as the indication for surgery, the size and the site of perforation, presence of chronic infection and general patient’s health e.g. diabetic

4) Hearing loss- this is very rare, but potentially with any ear surgery there is small risk of deteriorating the hearing rather than improving it.

Expectations and Advice following Myringoplasty/ Tympanoplasty surgery 

  • You may wake up with a head bandage around your head. If so, this will be removed the following day

  • You can go home the day after the surgery or later the same day

  • There will be some packing inside your ear. Do not remove any pack from your ear

  • The ear pack must be removed within 2-3 weeks. You should have an outpatient appointment before the end of this period

  • Do expect sensations of ear blockage and pressure while having the pack in your ear

  • Do expect mild dizziness/ instability of balance

  • You may have a small bloodstained discharge “ooze” in the first 24-48 hrs

  • Do not expect any improvement in hearing before the ear pack is removed or even the first few weeks after packs are removed

  • There should be no increase in pain, discharge or bleeding

  • Avoid getting water on the wound or in the ear

  • Off work/ school for about 10 days. A “sick note” will be provided

  • Please contact your GP during the working hours or contact the hospital where the surgery took place for any further advice or assistance.

Please note that the details in this section are for general information only. You should always discuss the risks, limitations and complications of your specific operation with your surgeon.