Myringoplasty

What is myringoplasty?

Myringoplasty is a surgery done to repair a ruptured eardrum. Your eardrum (tympanic membrane) is a thin, dime-sized piece of tissue located between your middle ear and outer ear. It helps you hear by vibrating in response to sound waves.

Your eardrum can tear or rupture as a result of ear infections, head trauma, sticking objects in your ear, sudden loud noises and more. Myringoplasty repairs the hole in your eardrum and reduces your risk for further health issues such as vertigo, mastoiditis (an infection of the bone behind your ear) and, in severe cases, permanent hearing loss.

Myringoplasty is one of the most common procedures performed by otolaryngologists (specialists who treat conditions of the ear, nose and throat). Children are more likely to need myringoplasty, but sometimes, adults need the procedure, too. Most people only need myringoplasty in one ear (unilateral myringoplasty). But in some cases, people need it in both (bilateral myringoplasty).

Who needs myringoplasty?

In most cases, a ruptured eardrum heals on its own in just a few weeks. Your healthcare provider may recommend myringoplasty when you or your child:

• Has a ruptured eardrum that hasn’t healed within three months.
• Has chronic or recurring (returning) ear infections.
• Has hearing loss due to a ruptured eardrum.
• Sustains trauma that results in a perforated (torn) eardrum.

What are the different types of grafts used in myringoplasty?

Surgeons use different materials to repair ruptured eardrums, including:

• Synthetic materials. Surgeons may use gel foam, surgical paper or other synthetic materials to patch the hole (paper patch myringoplasty).
• Temporalis fascia. Your temporalis fascia is a strong layer of connective tissue that covers your temporalis muscle. Your surgeon can harvest a small piece of your fascia and use it to patch the hole in your eardrum.
• Perichondrium. Your perichondrium is a layer of connective tissue that covers the elastic cartilage in your ear. Your surgeon can harvest some of this tissue and use it to perform the myringoplasty.
• Fat. In some cases, surgeons take fat tissue from your earlobe and use it to repair your eardrum (fat graft myringoplasty).
• Cartilage. Your surgeon might also take a small piece of your cartilage to patch the hole in your eardrum (cartilage myringoplasty).

How should I prepare for myringoplasty?

Your healthcare provider will give you a detailed list of preoperative instructions and tell you how to prepare for myringoplasty. In general:

• Be sure to tell your surgeon about any medications or supplements you’re currently taking.
• Arrange for a friend or family member to drive you to and from the hospital the day of your procedure.
• Make arrangements to take a few days off work or school to recover.

What happens during myringoplasty?

Most of the time, providers perform myringoplasty under general anesthesia in a hospital. But some people can have it done under local anesthesia in an office setting. Ask your healthcare provider which option is best for you or your child.

During myringoplasty, your surgeon will:

1. Access your eardrum through your ear canal or through an incision (cut) made behind your ear.
2. Prepare the area around the hole so the graft can attach. This involves slightly roughening the tissue.
3. Harvest tissue from another part of your ear to create a graft, or “patch” (if your surgeon uses synthetic material, such as gel foam, they’ll skip this step).
4. Place the graft over the hole in your eardrum.
5. Fill your ear with cotton packing.
6. Place a bandage over the outside of your ear.

Most myringoplasties take between 30 and 90 minutes to complete.

What happens after myringoplasty?

If you had general anesthesia, you’ll go to a recovery area following your procedure. Your medical team will monitor you while you wake up. In most cases, you’ll go home the same day.

Your surgeon will also go over postoperative instructions and give you prescription medications to help with your recovery.

What are the advantages of myringoplasty?

Myringoplasty offers a number of benefits:

• The procedure has high success rates, up to 94%.
• Success rates are similar among children and adults alike.
• Most people who undergo myringoplasty report improved hearing.
• Young children who undergo myringoplasty can reduce their risk of language delays due to hearing loss.

What are the risks or complications of myringoplasty?

Though myringoplasty complications are rare, they can happen. Possible risks include:

• Infection.
• Tinnitus (ringing in your ears).
• Dizziness.
• Hearing loss.
• Graft failure (myringoplasty failure symptoms include severe bleeding, infection and taste distortion).
• Recurring (returning) hole in your eardrum.

How long does it take to recover from a myringoplasty?

Generally, it takes one to two weeks to recover after myringoplasty. Adults should plan to take at least a week off from work. Children should also stay home from school for a week.

Your healthcare provider will see you for a follow-up visit approximately four to six weeks after your surgery.

How can I care for myself during myringoplasty recovery?

Your surgeon will give you a list of instructions for your specific situation. Here are some general guidelines for myringoplasty aftercare:

• Take all medications exactly as prescribed by your healthcare provider.
• Don’t remove your dressing or bandages except to put antibiotic ear drops in your ear canal (your provider will show you how to do this).
• Rest as much as possible.
• Sneeze with your mouth closed.
• Avoid blowing your nose.
• Avoid showering until your surgeon gives you the OK (baths are fine, but be sure to pack your ear with cotton to keep water out of your ear canal).
• Avoid swimming for several weeks.

What is the success rate of myringoplasty?

Surgeons have been performing myringoplasty in the U.S. since the mid-1960s. Since then, a wide range of studies have examined the success rates for the procedure. The current overall success rate for myringoplasty falls around 90%.

When should I see my healthcare provider?

Following myringoplasty, call your healthcare provider if you or your child develops:

• A fever over 103 degrees Fahrenheit (39.4 degrees Celsius).
• Ear pain that doesn’t go away with medication.
• Severe nausea.
• Weakness of your facial muscles.
• Breathing difficulties.
• Tinnitus.
• Dizziness that doesn’t go away.
• Severe bleeding from your ear.

A note from Cleveland Clinic

Myringoplasty is a common surgical procedure to repair a ruptured eardrum. Your healthcare provider will probably try conservative treatments before recommending myringoplasty. But if you or your child has a ruptured eardrum that won’t heal — especially after three months — it might be time to explore this procedure.