Tympanoplasty
What is a hole in the ear drum?
A hole in the ear drum or perforation is usually caused by an infection or injury to the ear drum. Quite often the hole heals by itself. Sometimes it does not cause any problem. However, in certain cases, it can cause ear discharge. If the hole in the eardrum is also large, then the hearing may be reduced. A hole in the ear drum can be diagnosed by your doctor with the use of specialized equipment.
What type of surgery is needed for a non-healing ear drum hole?
The operation to correct a hole in the ear drum is called myringoplasty or tympanoplasty. The main reason for having the operation is to prevent water getting into the middle ear, something that can cause recurrent ear infections and discharge. Occasionally the operation can also improve hearing.
If the hole in the ear drum is fresh then a wait and watch policy for sometime should be adopted as there is a chance of it healing by itself. You should discuss this with your doctor.
How is the operation done?
The operation is done usually with the patient asleep (general anaesthesia).
A cut is made behind the ear or above the ear opening. Occasionally the surgeon might need to widen the ear canal if it is narrow to gain access to the perforation. The material to patch the ear drum (the graft) is taken from under the skin (temporalis fascia) and is placed against the ear drum. Antibiotic dressing is then placed in the ear canal together with a head bandage overnight.
The operation can close a small hole on the ear drum 9 out of 10 times. For larger holes the success rate is not quite so good.
What are the possible complication?
Complications are rare but as for any operation you need to be aware of them before giving your consent.
Taste disturbance: The taste nerve for the front of the tongue runs very close to the ear drum and may occasionally be damaged during the operation. In such a case you might experience an abnormal taste on one side of the tongue. This is usually temporary and only rarely permanent.
Dizziness: If this happens it is usually temporary for a few hours following surgery.
Hearing loss: This happens extremely rarely if there is injury to the inner ear during surgery.
Tinnitus: This happens very rarely if there is associated hearing loss.
Facial nerve paralysis: The nerve for the muscles of the face runs through the ear. This complication is extremely rare with this operation.