Myringoplasty is a procedure carried out to repair a perforated eardrum. A perforation of the eardrum, also called the tympanic membrane, typically occurs as a result of infection or injury. When the eardrum is perforated, it is at risk of repeated episodes of infection, and both the perforation and the infection can affect an individual’s hearing. Eardrum repair surgery is a relatively simple procedure that takes about 60 to 90 minutes to complete.
The eardrum is a thin disc of taut skin that separates the outer and inner ear, and it is an essential part of the process that converts vibrations into sound. When vibrations are received in the outer ear, they cause the eardrum to vibrate. This vibration is detected by the ossicles, three bones situated behind the eardrum in the middle ear. The ossicles amplify the vibrations and transfer them through the middle ear to the inner ear, where they are detected by the cochlea, a structure that sends signals to the brain. The brain then interprets those signals as sound.
When the eardrum is perforated, the entire hearing process can be interrupted, because the presence of a hole prevents the membrane from vibrating effectively. In addition, the perforation in the eardrum allows the passage of bacteria from the outer ear to the middle and inner ear, which can result in chronic infection. Sometimes, a perforated eardrum can heal without treatment, but if spontaneous healing does not occur and the perforation results in hearing loss or repeated infection, myringoplasty is necessary to repair the eardrum.
The eardrum repair procedure usually is carried out under general anesthetic; for people who cannot tolerate general anesthetic for medical reasons, a local anesthetic can be used. During the operation, the surgeon makes a small incision in front of or behind the ear. Through this hole, a small piece of skin is inserted and placed over the hole in the ear drum. This skin graft covers the hole and will become part of the eardrum itself as healing proceeds.
In most cases, a person who has myringoplasty can return home the same day. He or she generally can resume normal activities after about two weeks, after a follow-up appointment to determine how well the graft is healing. It is recommended that someone who has undergone eardrum repair surgery consult with his or her doctor before resuming or starting an exercise program.
Myringoplasty has some specific risks and potential complications. One possibility is that the graft might fail to become part of the eardrum, which could necessitate a second procedure to remove or replace the graft. Some people who undergo this procedure experience episodes of tinnitus, in which a high-pitched sound is heard in the affected ear. Rarely, the myringoplasty itself might lead to further loss of hearing or to changes in how the individual experiences taste.