Tympanic membrane perforation

A tear in the eardrum — a “perforated eardrum” — can follow an infection, surgery or an injury. Most perforations heal without any treatment, but once they have been present for several months they are less likely to close on their own. The decision to repair a perforation surgically depends on several factors, including the patient’s age and the size and location of the tear.

Myringoplasty

The simplest repair is called a myringoplasty. It works best for relatively small holes. In this procedure, the hole is covered with a small piece of special paper that seals it temporarily, encouraging the body’s normal healing. Fat taken from the earlobe is sometimes used as well.

Tympanoplasty

Another common operation to repair a perforation is tympanoplasty. The tear is closed with a graft of fascia or connective perichondrium taken from beneath the skin.

A tympanoplasty can sometimes be carried out entirely through the ear canal. When the canal is too narrow, or the hole too large to be seen fully through it, the surgeon reaches the eardrum through an incision behind the ear.

Stapedotomy

Stapedotomy is a surgical treatment for the conductive hearing loss caused by otosclerosis. This condition affects up to 2% of the population. It often runs in families, but it can also appear on its own with no family history. The hearing loss is usually noticed when those affected reach their twenties, although it can begin later in life.