Eardrum repair surgery

Eardrum repair surgery

Before the eardrum repair surgery

Eardrum repair surgery types

Recovery of eardrum repair surgery

Eardrum repair surgery risks and complications

A perforated eardrum means there is a hole in the eardrum, which may have been caused by infection or injury. Quite often a hole in the eardrum may heal itself. Sometimes it does not cause any problems. However, it may cause recurrent infections with a discharge from the ear. If you have an infection you should avoid getting water in the ear. If the hole is large then you may experience some hearing loss. A hole in the eardrum can be identified by an ENT specialist using an instrument called an ‘auriscope'.

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What are the eardrum symptoms?

Signs and symptoms of a ruptured eardrum may include:

• Ear pain that may subside quickly
• Mucus like, pus-filled or bloody drainage from your ear
• Hearing loss
• Ringing in your ear (tinnitus)
• Spinning sensation (vertigo)
• Nausea or vomiting that can result from vertigo

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Before the eardrum repair surgery

Tell the health care provider:

• What allergies you or your child may have to any medicines, latex, tape, or skin cleanser
• What medicines you or your child is taking, including herbs and vitamins you bought without a prescription

On the day of the surgery for children:

• Follow instructions about not eating or drinking. For infants, this includes breastfeeding.
• Take any needed medicines with a small sip of water.
• If you or your child is ill on the morning of surgery, call the surgeon right away. The procedure will need to be rescheduled.
• Arrive at the hospital on time.

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How does eardrum repair surgery perform?

There are many ways an eardrum perforation can occur. An infection behind the eardrum in the middle ear may cause a rupture of the eardrum. Trauma to the ear may result from an object entering the ear canal and puncturing the eardrum. A traumatic blow to the ear with a cupped hand can rupture the eardrum. Hot welding slag can burn a hole through the eardrum. After a ventilation tube has been extruded or is removed, the opening usually closes; in some cases, a permanent opening of the eardrum may occur. Chronic ear problems such as deep retraction pockets and cholesteatoma​​ can weaken and erode the eardrum, resulting in a defect or perforation.

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Eardrum repair surgery types

Myringoplasty

If the hole or tear in your eardrum is small, your doctor may first try to patch the hole with gel or a paper-like tissue. This procedure takes 15 to 30 minutes and can often be done in the doctor’s office with only local anesthesia.

Tympanoplasty

A tympanoplasty is performed if the hole in your eardrum is large or if you have a chronic ear infection that cannot be cured with antibiotics. You will most likely be in the hospital for this surgery and will be placed under general anesthesia. You will be unconscious during this procedure.

First, the surgeon will use a laser to carefully remove any excess tissue or scar tissue that has built up in your middle ear. Then, a small piece of your own tissue will be taken from a vein or muscle sheath and grafted onto your eardrum to close the hole. The surgeon will either go through your ear canal to repair the eardrum, or make a small incision behind your ear and access your eardrum that way.

This procedure typically takes two to three hours.

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Ossiculoplasty

An ossiculoplasty is performed if the three tiny bones of your middle ear, known as the ossicles, have been damaged by ear infections or trauma. This procedure is also performed under general anesthesia. The bones can be replaced either by using bones from a donor or by using prosthetic devices.

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Recovery of eardrum repair surgery

It usually takes a few weeks for your eardrum to heal. A follow-up appointment for about two or three weeks after your operation will be arranged before or soon after leaving hospital.

After your surgery, your doctor will fill your ear with cotton packing. This packing should remain in your ear for five to seven days after your surgery. A bandage is usually placed over your entire ear to protect it. People who undergo an eardrum repair procedure are typically released from the hospital immediately.

You may be given ear drops after the surgery. To apply them, gently remove the packing and put the drops in your ear. Replace the packing and don’t put anything else in your ear.

Try to prevent water from entering your ear during recovery. Avoid swimming and wear a shower cap to keep water out when you bathe. Do not “pop” your ears or blow your nose. If you need to sneeze, do so with your mouth open so that pressure does not build up in your ears.

Avoid crowded places and people who may be sick. If you catch a cold after surgery, it could increase your risk of contracting an ear infection.

After surgery, you may feel shooting pain in your ear or you may feel as though your ear is filled with liquid. You may also hear popping, clicking, or other sounds in your ear. These symptoms are usually mild and improve after a few days.

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Eardrum repair surgery risks and complications

• Hearing loss: There is a slight chance of hearing loss in the inner ear. This loss can be complete and permanent.
• Dizziness: Some patients experience dizziness that resolves within a day of surgery. It is not likely for dizziness to be a persistent problem.
• Facial paralysis: The nerve that innervates the muscle of the face courses through the ear. Therefore, there is a slight chance of a facial paralysis. The facial paralysis affects the movement of the facial muscles for closing of the eye, making a smile and raising the forehead. The paralysis could be partial or complete. It may occur immediately after surgery or have a delayed onset. Recovery can be complete or partial.
• Tinnitus: Tinnitus, or noises in the ear, can occur with surgery, but is an uncommon post-operative problem.
• Taste abnormalities: A small nerve that innervates some of the taste and salivary function courses through the ear. After ear surgery, some patients experience an abnormal taste in the mouth or some dryness of the mouth. Many times, this problem will improve over time.

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Should all eardrum perforations be fixed?

Some perforations do not require any special treatment. When an eardrum perforates during a bad ear infection, the infected ear fluid usually drains out through the hole. After a few day, the hole will usually close all by itself. Sometimes the infection lingers for a while and may need additional treatment with medicines or ear drops. After the infection is finally clear, the hole may still close all by itself.

If a perforation has been present for more than 3 months without infection or drainage it is unlikely to close by itself. At this point, your doctor may recommend that you consider having the hole closed surgically. The decision to surgically close a perforation is sometimes a difficult one to make. It depends on a variety of factors including the patient’s age, history of infections, problems with the other ear, and the degree of hearing loss (if any). A pediatric ear, nose, and throat specialist can help you decide if it’s the right time to repair your child’s eardrum perforation.

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Eardrum repair surgery success rate

In most cases, eardrum repairs are very successful. More than 90 percent of patients recover from tympanoplasty with no complications. The outcome of the surgery may not be as good if the bones of your middle ear need to be repaired in addition to your eardrum.

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