Myringoplasty: operation to repair a perforated eardrum

What is myringoplasty?

Myringoplasty refers to a surgical intervention aimed at repairing the tympanic membrane when it has not healed naturally from a perforation. The primary objective of the surgery is to bring back the normal protective and sound transmission functions of the membrane.

Who needs myringoplasty?

Myringoplasty surgery is necessary when the tympanic membrane has been perforated due to trauma and has healed on its own.

Preoperative evaluation

Myringoplasty surgery is performed after a careful medical evaluation that involves first listening to the patient's history. This is followed by an ENT examination, an otoscopic and endoscopic examination to assess the appearance of the membrane, the size of the perforation, and the condition of the ear more generally.

Audiometric examination is also performed to assess any hearing deficit and type of damage.

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How the myringoplasty is performed

Myringoplasty surgery can be performed under local anesthesia or general anesthesia, depending on the patient's medical history and their condition, using a microscope or endoscope. To repair the eardrum, tissue is typically sourced from the patient themselves.

Intra-auricular myringoplasty

Myringoplasty surgery is performed intra-auricularly: through the external ear canal and without leaving visible incisions. That being said, this is only possible when the perforation is small and located in the back portion of the tympanic membrane.

Retroauricular myringoplasty

Myringoplasty surgery can also be performed retroauricularly when perforations of the anterior portion of the tympanic membrane or very large perforations are found. In this case, it is necessary to make a slightly larger skin incision behind the auricle, with application of a bandage to prevent the formation of blood clots, which could interfere with tissue healing.

How long does ear myringoplasty take?

The duration of myringoplasty surgery varies depending on the surgical difficulty, the patient's condition, and consequently the type of anesthesia chosen. However, it is generally performed on a same-day basis, where the patient is often discharged the next day.

What happens after the myringoplasty?

Myringoplasty surgery involves one or two days of hospitalization, with a margin for return to work of 7 to 10 days. In addition, 20 to 30 days after the procedure, an audiometric examination checks the effective functional recovery of the individual's hearing ability.

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Are there any complications after this surgery?

Myringoplasty surgery has a 95% chance of success and has virtually no contraindications related to the patient's age, location, or size of the perforation.

Reperforation

The chance that a new perforation will occur after myringoplasty surgery is very low indeed. The only risk factor to date is new infectious episodes, such as acute otitis.

Hearing loss

After myringoplasty surgery, auditory recovery may be total, partial, or even nil. This can be attributed to scarring that impedes the normal movement of the auricular ossicles, or if the reconstructed tympanic membrane is too thick. In such situations, the patient may experience tinnitus or ongoing ringing in the ears.

Cholesteatoma

One of the possible consequences of myringoplasty surgery is cholesteatoma, a form of chronic otitis media that develops as skin builds up in the middle ear. If superficial, it can be removed in an outpatient during the first postoperative checkup. However, in less frequent cases, it may also requires surgery.

Facial weakness

An often partial and transient condition of facial waekness may occur following myringoplasty. One of the main causes is attributed to anasthesia.

Dizziness

Dizziness is another potential side effect of myringoplasty surgery and may be accompanied by a decline in preoperative hearing. While these symptoms often resolve on their own, additional surgery may be necessary.

Irreversible sensorineural deafness

A very rare risk that may be incurred after myringoplasty surgery is irreversible sensorineural deafness. We always recommend that a professional be consulted to check the level of hearing loss.

When should I see a doctor?

If you experience even one of the previously listed symptoms, we recommend contacting your doctor or specialist or visiting one of our Amplifon centers to take a test and check the status of your hearing ability.

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Myringoplasty