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Eardrum Repair

Eardrum Repair

An eardrum repair is a surgical procedure used to fix a perforation (hole or tear) in the eardrum. The eardrum (tympanic membrane) is a thin, tightly stretched skin-like tissue that separates your ear canal from the middle ear. When your outer ear funnels sound waves into your ear canal, the purpose of the eardrum is to vibrate. The middle and inner ear will then change these vibrations to nerve signals which your brain interprets as sound. If your eardrum is ruptured, it can’t vibrate properly causing hearing problems.

Ear with aching in need of eardrum repair surgery

What Can Cause a Perforated Eardrum?

There are several causes for holes or tears in the eardrum. This can range from:

Ear anatomy model to show the ear drum before repair surgery
  • The use of items that cause damage to the ear canal or eardrum, such as cotton swabs.
  • Middle ear infections within the middle or inner ear that cause the eardrum to burst open due to fluid or pus buildup.
  • Very loud noises such as explosions can damage the eardrum, due to very strong sound waves.
  • Head trauma, either a direct blow to the ear that causes the eardrum to tear, or a severe head injury that breaks bones near the eardrum.
  • Sudden pressure changes that rupture the eardrum (barotrauma), such as flying in an airplane, scuba diving, or traveling above sea level.

What Are the Symptoms of an Eardrum Perforation?

If you experience hearing loss, ringing in your ears, nausea or vomiting, spinning sensations (vertigo), bloody or pus-like drainage from the ear canal, mild to severe pain that suddenly decreases, or weak facial muscles, you’re likely to have a perforation in your eardrum. If you suspect this then you should schedule a consultation with one of our ENT specialists to have them look at your inner ear.

Boy getting an ear check-up before eardrum repair

How Is an Eardrum Perforation Diagnosed?

One of our ENT specialists will determine whether you have a ruptured eardrum with a visual inspection of the inner ear. Additional tests can be done to determine the cause including:

A consultation between an ear surgeon and patient about ear drum repair
  • Laboratory tests on any discharge from the ear to test for bacterial infection.
  • Audiology exam to measure how well you hear varying volumes and pitches.
  • A tympanometry test, which determines how well your eardrum responds to slight changes in air pressure. A tympanometer is used for this with an insert in your ear canal
  • A tuning fork test, which detects hearing loss. This works by striking two-pronged forks to create sound. Depending on how much of this sound you can hear, determines whether the hearing loss is from a damaged middle ear, or damaged sensors/nerves, or both.

If it is found that you do have an eardrum perforation our ENT specialists will recommend either an eardrum patch, or a tympanoplasty to repair it.

3 Types of Eardrum Surgery Treatment Options

While most ruptured eardrums will heal on their own without treatment in just a few weeks, sometimes this isn’t always the case.

  • 1. Myringoplasty. If you have a relatively small hole or tear in your eardrum, one of our ENT specialists will patch the hole with a gel or paper-like tissue. This procedure doesn’t take very long, anywhere from 15-30-minutes, and can be done under local anesthesia.
  • 2. Tympanoplasty. If an eardrum patch is not effective, the hole in the eardrum is too large, or you keep having chronic ear infections that don’t respond to antibiotics, then a tympanoplasty is recommended. With this procedure, one of our ENT specialists will remove any scar tissue or excess tissue within the middle ear, then take a small piece of your own tissue (such as a muscle covering called fascia) and graft it onto your eardrum to close the hole. This surgical procedure can be done through the ear canal or by making an incision behind the ear. Tympanoplasty is an outpatient procedure, takes approximately 1-2 hours, and requires general anesthesia.
Ear drum repair surgery
  • 3. Ossiculoplasty. In severe cases where your eardrum is perforated and the middle ear bones (ossicles) are damaged either from trauma or ear infections, then an ossiculoplasty is recommended. Your middle ear bones will be replaced using prosthetic implants and your eardrum is repaired.
Pre-Surgery Prep for an Eardrum Repair

Pre-Surgery Prep for an Eardrum Repair

During your appointment with us, we will ask you about any medications or supplements you are taking, and whether you have allergies to certain medications that may be used during the surgical procedure. We ask that you avoid eating or drinking anything past midnight on the day prior to surgery, as this reduces your risk of complications from anesthesia.

What Does Outlook and Recovery Look Like After Eardrum Repair?

To protect the ear after an eardrum repair packing will be placed in the ear, and it will need to stay there for the first 5-7 days. In some cases, you may be given a dressing that goes over top of the ear. If you are prescribed ear drops, you can remove the packing to apply them, but do not put anything else in the ear, and always replace the dressing.

We ask that you do not “pop” your ears, blow your nose, swim, travel by air, or allow water to get into the ear. During bathing time, wear a shower cap to prevent water from getting into the ears or drenching your bandages.

Any mild drainage that you have should be gently wiped away.

The outlook for eardrum repair surgery is very successful with the majority of patients recovering with no complications.

Ear anatomy model used to demonstrate eardrum repair
Young ear patient checking her doctors ears in a cute way

Have Questions About Eardrum Repair Surgery?

If you are currently suffering from the symptoms of a perforated eardrum, please get in touch immediately at 407-677-0099. Our ENT specialists are happy to take a look and get you on the road to recovery.

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Painful ear infections are a rite of passage for children—by the age of five, nearly every child has experienced at least one episode. Most ear infections either resolve on their own (viral) or are effectively treated by antibiotics (bacterial). But sometimes, ear infections and/or fluid in the middle ear may become a chronic problem leading to other issues such as hearing loss, behavior and speech problems. In these cases, insertion of an ear tube by an otolaryngologist (ear, nose and throat specialist) may be considered.

Ear tubes are tiny cylinders placed through the ear drum (tympanic membrane) to allow air into the middle ear. They also may be called tympanostomy tubes, myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes. These tubes can be made out of plastic, metal or Teflon and may have a coating intended to reduce the possibility of infection. There are two basic types of ear tubes: short-term and long-term. Short- term tubes are smaller and typically stay in place for six months to a year before falling out on their own. Long-term tubes are larger and have flanges that secure them in place for a longer period of time. Long-term tubes may fall out on their own, but removal by an otolaryngologist is often necessary.
Ear tubes are often recommended when a person experiences repeated middle ear infection (acute otitis media) or has hearing loss caused by the persistent presence of middle ear fluid (otitis media with effusion). These conditions most commonly occur in children, but can also be present in teens and adults and can lead to speech and balance problems, hearing loss, or changes in the structure of the ear drum. Other less common conditions that may warrant the placement of ear tubes are malformation of the ear drum or eustachian tube, Down Syndrome, cleft palate and barotrauma (injury to the middle ear caused by a reduction of air pressure, usually seen with altitude changes such as flying and scuba diving).
Ear tubes are inserted through an outpatient surgical procedure called a myringotomy. A myringotomy refers to an incision (a hole) in the ear drum or tympanic membrane. This is most often done under a surgical microscope with a small scalpel (tiny knife), but it can also be accomplished with a laser. If an ear tube is not inserted, the hole would heal and close within a few days. To prevent this, an ear tube is placed in the hole to keep it open and allow air to reach the middle ear space (ventilation).

Each year, more than half a million ear tube surgeries are performed on children, making it the most common childhood surgery performed with anesthesia. The average age for ear tube insertion is one to three years old.

Inserting ear tubes may:

  • Reduce the risk of future ear infection
  • Restore hearing loss caused by middle ear fluid
  • Improve speech problems and balance problems
  • Improve behavior and sleep problems caused by chronic ear infections
A light general anesthetic (laughing gas) is administered for young children. Some older children and adults may be able to tolerate the procedure without anesthetic. A myringotomy is performed and the fluid behind the ear drum (in the middle ear space) is suctioned out. The ear tube is then placed in the hole. Ear drops may be administered after the ear tube is placed and may be necessary for a few days. The procedure usually lasts less than 15 minutes and patients awaken quickly.

Sometimes the otolaryngologist will recommend removal of the adenoid tissue (lymph tissue located in the upper airway behind the nose) when ear tubes are placed. This is often considered when a repeat tube insertion is necessary. Current research indicates that removing adenoid tissue concurrent with placement of ear tubes can reduce the risk of recurrent ear infection and the need for repeat surgery.

After surgery, the patient is monitored in the recovery room and will usually go home within an hour if no complications occur. Patients usually experience little or no postoperative pain but grogginess, irritability, and/or nausea from the anesthesia can occur temporarily.

Hearing loss caused by the presence of middle ear fluid is immediately resolved by surgery. Sometimes children can hear so much better that they complain that normal sounds seem too loud.

The otolaryngologist will provide specific postoperative instructions, including when to seek immediate attention and to set follow-up appointments. He or she may also prescribe antibiotic ear drops for a few days.

To avoid the possibility of bacteria entering the middle ear through the ventilation tube, physicians may recommend keeping ears dry by using ear plugs or other water-tight devices during bathing, swimming and water activities. However, recent research suggests that protecting the ear may not be necessary, except when diving or engaging in water activities in unclean water such as lakes and rivers. Parents should consult with the treating physician about ear protection after surgery.

Consultation with an otolaryngologist (ear, nose and throat specialist) may be warranted if you or your child has experienced repeated or severe ear infections, ear infections that are not resolved with antibiotics, hearing loss due to fluid in the middle ear, barotrauma, or have an anatomic abnormality that inhibits drainage of the middle ear.

Myringotomy with insertion of ear tubes is an extremely common and safe procedure with minimal complications. When complications do occur, they may include:

  • Perforation—This can happen when a tube comes out or a long-term tube is removed and the hole in the tympanic membrane (ear drum) does not close. The hole can be patched through a minor surgical procedure called a tympanoplasty or myringoplasty.
  • Scarring—Any irritation of the ear drum (recurrent ear infections), including repeated insertion of ear tubes, can cause scarring called tympanosclerosis or myringosclerosis. In most cases, this causes no problem with hearing.
  • Infection—Ear infections can still occur in the middle ear or around the ear tube. However, these infections are usually less frequent, result in less hearing loss and are easier to treat—often only with ear drops. Sometimes an oral antibiotic is still needed.
  • Ear tubes come out too early or stay in too long—If an ear tube expels from the ear drum too soon (which is unpredictable), fluid may return and repeat surgery may be needed. Ear tubes that remain too long may result in perforation or may require removal by an otolaryngologist.