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Before you agree to have a myringoplasty operation to repair your perforated ear drum, it is important to know all you can about it. The information here is a guide to common medical practice. Each hospital and doctor will have slightly different ways of doing things when carrying out myringoplasty, so you should follow their guidance where it is different from the information given here. Because all patients, conditions and treatments vary it cannot cover everything. Use this information when making your perforated ear drum treatment choices with your doctors. You should mention any worries you have. Remember that you can ask for more information at any time.



What is the problem?

You have a hole in your ear drum which we call a perforation. This may have been caused by infection or injury. The perforation will make you more prone to repeated ear infections particularly if you get water in your ear. It may also affect your hearing.


What is the ear?

The ear has three parts; the outer ear, the middle ear and the inner ear.



  • The outer ear - This is the visible part of the ear, including the pinna and the ear canal. The fleshy pinna is shaped to gather sound and direct it along the ear canal towards the eardrum.

  • The middle ear - The eardrum is about eight millimetres (a third of an inch) across and made from thin skin, just like the top of a real drum. It marks the boundary between the outer ear and the air-filled middle ear. The cavity of the middle ear connects to the back of the nose through the Eustachian tube. It contains the ossicles, which are three tiny bones. These bones, the hammer, the anvil, and the stirrup, are attached to the eardrum on one side and the inner ear on the other. When sounds enter the ear, the eardrum vibrates. The vibrations are passed to the three tiny bones, which increase the vibrations and pass them to the middle ear.
Myringoplasty 2


  • The inner ear - The deepest part of the ear is the inner ear. It contains two fluid-filled organs. The semicircular canals, which are concerned with balance and a snail-shaped organ, called the cochlea. The movements of the tiny bones of the middle ear cause waves in the fluid inside the cochlea. The cochlea is lined with sensitive hairs, which trigger nerve signals that are sent to the brain. The brain decodes these signals allowing us to hear.


What has gone wrong?

The hole in your eardrum may result from repeated infections during your childhood, an injury or perhaps a previous ear operation. The hole in your eardrum can stop it from vibrating normally, causing some loss in hearing. It may allow germs in, causing infection in the deeper parts of your ear. This is more likely if water enters your ear while washing your hair, taking a shower or swimming.

Myringoplasty 3

The aims

The aim of a myringoplasty is to close the hole in your eardrum with a small skin graft. We usually take the skin for the graft through an incision just above your ear.


The benefits

Sealing the hole in your eardrum will help to prevent repeated ear infections. It may also improve your hearing. The amount that your hearing improves will depend on the size and position of the hole in your eardrum. Your surgeon should discuss this with you in detail and explain how much you can expect your hearing to improve.


Are there any alternatives?

You cannot take tablets or medicines to close a hole in your eardrum. Sometimes, small holes close by themselves if left.


What if you do nothing?

A small hole may close by itself but a larger one will not. As long you have a hole in your eardrum you have an increased risk of getting ear infections. This may cause a runny ear. You can try to prevent infection by keeping your ear dry. You will need earplugs for washing your hair, bathing, showering or swimming.


If the hole in your eardrum stops it from vibrating properly then you hearing will be impaired while the hole remains.


Who should have it done?

If you have a hole in your eardrum that is causing significant deafness, maybe with frequent ear infections, you should consider an operation to close the hole.


Who should not have it done?

If you have another medical condition that makes a general anaesthetic unsafe you should not have one. It may be possible to have the operation under local anaesthetic. Discuss this option with your surgeon and anaesthetist.


If the hole is not causing much deafness and you are happy to avoid ear infections by keeping your ear dry then you should not have the operation.


Author: Mr Robert Ruckley MB. ChB.  F.R.C.S. Consultant ENT surgeon.

© Dumas Ltd 2006

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