Myringoplasty is a surgical procedure aimed at repairing a perforation (hole) in the eardrum (tympanic membrane). The eardrum separates the outer ear from the middle ear and protects it from bacteria and debris. However, it can be damaged due to infections, trauma, or chronic ear conditions, leading to hearing loss, recurrent ear infections, or discomfort. Myringoplasty is typically done to restore the integrity of the eardrum, improve hearing, and prevent infection recurrence.
Myringoplasty focuses on the eardrum and does not involve the three tiny bones, known as the ossicles. The surgery is usually done for smaller perforations. If the middle ear structures are intact, this procedure can greatly improve hearing and quality of life.
Myringoplasty is primarily used to treat perforations (holes) in the eardrum. The procedure is often performed when non-surgical treatments, such as antibiotics or waiting for natural healing, have failed to close the perforation.
Perforations in the eardrum can allow bacteria and water to enter the middle ear, leading to repeated infections. Myringoplasty repairs the hole, preventing further infections.
The eardrum plays a key role in conducting sound to the inner ear. A perforated eardrum can impair hearing ability. By repairing the eardrum, myringoplasty can improve hearing in affected individuals.
Damage to the eardrum can result from trauma, such as from a loud noise, direct injury, the placement of an ear tube or sudden pressure changes (barotrauma). Myringoplasty is used to restore the integrity of the eardrum after such trauma.
In some cases, long-term ear infections can cause damage to the eardrum. Myringoplasty can help patients who suffer from chronic otitis media by repairing the eardrum and reducing the recurrence of infections.
By sealing the eardrum, myringoplasty helps prevent fluid accumulation, chronic irritation, and potential complications in the middle ear such as cholesteatoma.
The need for myringoplasty surgery typically arises when a person has a perforated eardrum that isn’t healing on its own and is causing symptoms. During the initial consultation, your ENT specialist will assess whether myringoplasty is the most appropriate treatment.
Common symptoms that might indicate a need for myringoplasty include:
If these symptoms persist, especially after medical management (like antibiotics or ear drops), an ENT specialist may recommend myringoplasty to close the eardrum perforation and alleviate these symptoms.
During myringoplasty, the procedure begins with the administration of local or general anesthesia to ensure the patient is comfortable and pain free. The surgeon then examines the ear using an otoscope to assess the size and location of the eardrum perforation and to ensure the middle ear is healthy. Access to the eardrum may be achieved through a small incision in the ear canal, or the surgeon may opt for a postauricular approach by entering through the back of the ear.
Next, the surgeon prepares a graft, typically taken from the patient’s own tissue (commonly from behind the ear or the tragus), which will be used to patch the perforation. They will lift your eardrum and place the graft underneath it. The graft will be supported by a dissolving sponge. Once the graft is in position, the surgeon closes any incisions made in the ear canal or behind the ear.
After most myringoplasties, patients are monitored for a short period before being discharged with post-operative care instructions, which include guidelines on keeping the ear dry and scheduling follow-up appointments. The entire procedure typically lasts about 1 to 2 hours,and patients can usually go home the same day. Occasionally, patients may stay overnight in hospital with a bandage to support their postarticular incision.
Myringoplasty is quite common in children, particularly with recurrent ear infections or persistent perforations in the child’s eardrum. Due to anatomical factors, children are more susceptible to ear infections.
Repairing a perforated eardrum in children is often prioritised to prevent long-term impacts on their speech and education.
The surgery may be performed through the child’s ear canal, or an incision behind the ear. During recovery your child might have mild ear pain, but keep in mind children recover quickly and the eardrum heals well in most children.
While adults also undergo myringoplasty, it is less common compared to children. Adults may seek this surgery due to chronic ear infections, trauma or hearing loss caused by a perforation.
In adults, the decision for surgery may also involve assessing the overall health of the middle ear and any potential complications from long-term conditions.
Myringoplasty may be an overnight or a day surgery, performed under general anaesthetic or a local anaesthetic, depending on the complexity of the procedure.
After myringoplasty surgery, the recovery process involves a few stages. It’s important to follow your ENT surgeon’s recommendations to ensure a smooth healing process in the weeks after the procedure.
You will be monitored for a few hours after the surgery to ensure there are no immediate complications from the anaesthesia or procedure. You’ll typically be discharged the same day if everything is stable, though some cases might require an overnight stay.
It’s common to feel some dizziness, ear fullness, or mild discomfort as your ear adjusts to the changes. This usually subsides in a few days. You may experience some ear pain or discomfort, which can be managed with prescribed painkillers. It’s generally mild and should improve within a few days.
A cotton dressing or ear packing may be placed in the ear canal to protect the surgical site. You may also have a bandage around your head to keep the ear protected.
The packing in your ear (if used) will typically be removed by your doctor during a follow-up visit 1–2 weeks after the surgery. During this time, the ear may feel clogged or slightly uncomfortable.
Some clear, pinkish, or blood-tinged drainage from the ear may occur for a few days, which is normal. However, excessive or foul-smelling discharge should be reported to your doctor.
You’ll be advised to avoid strenuous activities, heavy lifting, or bending over, as this can increase pressure in the ear and affect healing.
It is essential to keep the ear dry at all times. Avoid swimming, bathing, or any activity that could allow water to enter the ear. Use a shower cap or ear protection as recommended by your doctor.
It’s common to experience temporary hearing loss or muffled hearing after surgery due to packing or swelling. Once the packing is removed and the healing progresses, your hearing should gradually improve.
You may notice improved hearing within a few weeks to a couple of months, depending on how quickly your ear heals.
Regular follow-up appointments with your ENT specialist are important to monitor healing and ensure the graft has taken hold.
You can begin resuming non-strenuous, normal activities after the first couple of weeks, but you should still avoid activities that might affect the ear (like swimming or heavy lifting) for several weeks as advised by your doctor.
Most patients heal fully within 4 to 6 weeks, though in some cases, full hearing restoration and complete healing of the graft may take longer. Your doctor will monitor the graft to ensure it has taken hold and the perforation is fully closed.
Your ear may remain sensitive during the healing period. Sudden pressure changes (such as air travel or diving) should be avoided until your doctor confirms full healing.
Excessive Pain: If you experience severe pain not relieved by medication.
Heavy Drainage: Excessive or foul-smelling ear discharge.
Fever: A persistent fever could indicate infection.
Sudden Hearing Loss: If you experience sudden, severe hearing loss after surgery.
At Complete ENT, we understand that ear health is vital to overall well-being, which is why we take the time to thoroughly assess each individual’s unique situation, provide personalised treatment plans, and offer comprehensive support throughout the recovery process.
Our approach emphasises clear communication and education, helping patients feel informed and confident in their treatment decisions. With a focus on achieving the best possible results, we are dedicated to restoring your hearing and quality of life.
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07 3905 5999