Eardrum Repair – Tympanoplasty

Quite a recurrent medical issue ENT specialist at Herzliya Medical Center deal with is the defect or rupture of the tympanic membrane – a delicate tissue that is located between your ear canal and middle ear – which is sometimes accompanied by other pathologies of the middle ear. Any disease of the ear must be considered with the greatest medical care, as, left untreated, they might result in permanent hear loss. A reliable and a relatively safe solution the department offers is perforated eardrum surgery performed with constantly evolving surgical techniques and refined membrane replacing materials.

Tympanoplasty (aka. perforated eardrum repair) is a surgical procedure that aims to reconstruct a damaged tympanic membrane, perforated mostly due to an infection or a traumatic event. Sometimes the purpose of an ear surgery can be to repair the small bones of the middle ear in the vicinity of the eardrum and to improve hearing. The positive outcome of the eardrum repair is often measured in terms whether the procedure has managed to eradicate inflammatory or infectious diseases of the middle ear.

What are the indications of perforated eardrum surgery?

• A recurring, antibiotics-resistant ear infection that has damaged the eardrum
• A foreign object or an accident caused rupture or a hole in the eardrums
• Extra tissue accumulated around the eardrums

How is eardrum repair performed at Herzliya Medical Center?

A detailed and precise pre-op medical assessment and the careful selection of the grafting technique are harbingers of a positive outcome of perforated eardrum surgery. The examination includes an audiogram, otoscopy, fistula testing, and blood and urine lab tests.

Most surgical techniques of eardrum repair involve the use of skin grafts harvested from a vein or muscle or made out of synthetic material.

Patients are usually given general anesthesia so the procedure does not involve any pain. The ENT surgeon makes the incision behind the ear or in the ear canal and uses an operating microscope to be able to examine meticulously the ear structure.

Perforated eardrum surgery may consist of multiple steps:

• Clearing the eardrum and the middle ear from any infected tissue.
• Correct a tear or hole in the eardrum through tissue grafting.
  To repair smaller ruptures the surgeon places a special gel or paper on the eardrum. This type of eardrum repair, called myringoplasty, is a relatively simple procedure that can be done with local anesthetics and won’t take longer than 30 minutes.

Tympanoplasty grafting ideally proceeds as follows:

• Tissue is harvested from a vein or from the tragus (a cartilaginous piece of skin in front of the ear).
• The tissue is pressed and dried.
• The surgeon places an absorbable gel under the eardrum to hold the graft.
• Graft is inserted under the ruptured eardrum, which is then placed back to its original position.
• The graft is fixed with a thin sheeting so that the graft won’t be displaced due to physical impact.
• The incision is stitched up, well buried in the natural creases of the ear.
• Under normal circumstances patients are discharged on the same day, but the patch and packing can only be removed after about 10 days.

Possible complications of perforated eardrum surgery

Although eardrum repair is evaluated successfully in more than 90% of cases, it still carries some risks:

• Recurrent perforation of the graft
• Hearing loss
• Echo-like noises in the ear
• Stenosis of the ear canal
• Abnormal scarring in the middle ear