Tympanic membrane perforation (hole in the ear drum) and repair (Tympanoplasty) 

 

Tympanic Membrane Perforations-why do they happen? 

 

Holes in the ear drum can occur following infections, injury to the ear drum and surgery including insertion of grommets. 

 

 

What should I do if I have a hole in the ear drum? 

 

There are many people in the community who have holes in their ear drums who are completely unaware of this. If it is not causing problems then no treatment is required. 

Perforations can be responsible for recurring ear infections and can be associated with hearing loss.  

 

How should it be managed? 

 

1 Management without an operation- in this case you could consider using an ear plug to prevent water getting through the hole in the ear drum which may lead to an infection. Ear plugs can be bought at chemists and online and custom-made ear plugs can also be fitted. If an infection does occur this is best treated with ear drops 

 

 

2 Management with an operation- an operation can be performed to repair the ear drum perforation- called myringoplasty or tympanoplasty. This allows the ear drum to heal and for the ear to be then treated like a normal ear without the need for any special precautions.  

 

This operation is performed as a day case under general anaesthetic. A graft is taken and placed under the ear drum to act as a scaffolding for the edges of the perforation to grow over this and seal the hole. There are several different methods to achieve this and the detail is discussed at the time the decision is made to have the operation. 

 

If I have an operation are there any risks? 

 

The operation carries certain risks as is common with any operation. The main risk is that the operation may not work if the ear drum fails to heal properly. The risk of this happening depends on the size and position of the hole but overall success rates are in the order of 80-85%. Other risks are much less common but because the operation is on the ear there is a risk of causing damage to the hearing, tinnitus (ringing in the ear), dizziness (which is usually temporary) and taste disturbance on that side of the tongue which again is usually temporary. 

 

At the same time as repairing the ear drum if hearing loss is an issue, the small bones behind the ear drum can be assessed and if appropriate a small implant may be inserted to reconnect any pre-existing damaged ossicle (ossiculoplasty).