Patient education: Perforated eardrum repair (The Basics)

What is a perforated eardrum? — 

The eardrum is the thin layer of tissue between the ear canal and middle ear. "Perforated" means the eardrum has a hole or tear in it. Sometimes, this needs to be repaired with surgery. Eardrum repair surgery is also called "myringoplasty" and "tympanoplasty."

To repair the eardrum, the doctor uses small pieces of tissue to patch the tear or hole. The tissue can come from other parts of the body (called a "natural graft"), or the doctor can use artificial materials. Sometimes, other parts of the ear, such as the ear bones, might need to be repaired at the same time.

Doctors can do this eardrum repair surgery in 2 ways:

●Open surgery – The doctor makes a cut ("incision") in the skin behind the ear. This lets them see directly inside the ear canal to do the surgery. They can also use this incision to get tissue for the graft.

●Closed ("transcanal") surgery – The doctor uses a thin tube with a tiny camera and light on the end, called an "endoscope." They put the endoscope into the ear canal so they can see inside the ear. If they use a natural graft, they will usually take the tissue from behind the ear. In this case, they will make another incision behind the ear.

How do I prepare for eardrum repair? — 

The doctor or nurse will tell you if you need to do anything special to prepare.

Your doctor will ask about your "health history." This involves asking about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes prescription and "over-the-counter" medicines, plus any herbal supplements. It helps to write down and bring a list of your medicines, or bring a bag with all your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

Before the procedure, your doctor will do an exam. They might send you to get tests, such as a hearing test. These can help the doctor figure out if you have hearing loss. If you do, they might need to repair your ear bones, too.

You will also get information about:

●Eating and drinking before the procedure – You might need to "fast" before surgery. This means not eating or drinking anything for a period of time. Or you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure.

●What help you will need when you go home – For example, you might need someone else to bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during eardrum repair? — 

When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure you do not feel pain during the procedure. Types of anesthesia include:

•Local – This numbs a small part of your body so you don't feel pain.

•Sedation – This helps you relax and feel sleepy.

•General – This makes you unconscious so you can't feel, see, or hear anything during the procedure. You might get a breathing tube to help you breathe.

●You will get medicines to help control pain after the procedure. Most people do not have a lot of pain after eardrum repair.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●If the doctor is using a natural graft, they will make an incision in your scalp or the outside of your ear. Then, they will take out a tiny piece of tissue.

●The doctor will repair your eardrum and any other damaged parts of your ear.

●They will close any incisions and cover them with clean bandages. They might also put ointment or a special material in your ear canal to help with healing.

●How long the procedure will take depends on how many parts of your ear need repair. A simple procedure can take 15 to 30 minutes. More complicated procedures can take 2 to 3 hours.

What happens after eardrum repair? — 

You will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine to help with pain, if needed. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of eardrum repair? — 

Your doctor will talk to you about all the possible risks, and answer your questions. Possible risks include:

●Bleeding

●Infection

●The graft coming off

●Getting another hole in the eardrum

●Dizziness

●Injury to the nerves around the ear, which can lead to changes in taste or (very rarely) facial weakness

●Hearing loss

Some of these problems need treatment if they happen. For example, you might need another surgery if the graft does not fix the hole in your eardrum.

What else should I know? — 

Before you go home from the hospital, make sure you know what problems to look out for and when to call the doctor. Make sure you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

More on this topic

Patient education: Perforated eardrum repair – Discharge instructions (The Basics)
Patient education: Perforated eardrum (The Basics)
Patient education: Ear infections in adults (The Basics)
Patient education: Ear infections in children (The Basics)
Patient education: Audiometry (The Basics)

Patient education: Ear infections (otitis media) in children (Beyond the Basics)