Myringoplasty
Sometimes, a hole can develop in a person’s eardrum — a relatively common condition known as a tympanic membrane perforation. This can occur due to an infection or trauma. In many cases, the hole will close up and heal on its own.
However, if the body fails to heal naturally, medical intervention may be needed to ‘patch up’ the hole. This helps prevent further damage inside the ear, including infections that could lead to significant problems such as hearing loss.
What is Myringoplasty?
Myringoplasty is a specialised surgical procedure that repairs a perforation (hole) in the eardrum to improve a patient’s hearing ability and prevent water from entering the middle ear, which can cause infections. During the surgery, an ENT surgeon would gently access the eardrum through the ear canal. Depending on the size of the perforation, the hole would be repaired by placing a graft, usually made with tissues taken from the skin near the ear. This procedure is performed under general anaesthesia and is considered a Day Surgery procedure.
Who can perform Myringoplasty?
Myringoplasty is typically performed as a day surgery by an ENT surgeon. You can book an appointment at Aglow ENT Centre to determine if this procedure is suitable for you. Our ENT specialist, Dr Ker Liang, is a trained surgeon with 13 years of experience treating both adults and children for various ENT conditions.
What to Expect?
Understanding what to expect and being prepared for surgery can help calm patients’ nerves. Here are the steps you should know about before undergoing a Myringoplasty.
Before the Surgery
An initial consultation will be scheduled with your ENT specialist to assess your overall health. During this consultation, the specialist will review your medical history, including any existing conditions such as allergies or medications.
If you are on any of the following medications, be sure to let your doctor know before the surgery:
- Allergy medication
- Medication (e.g., Aspirin, Warfarin, etc) or supplements that act as blood thinners
During the Surgery
During the surgery, you will be placed under general anaesthesia. Once the medication starts working, our ENT surgeon will proceed with the following:
- A small cut is made either in the front, back, or inside the ear canal to obtain a piece of tissue (graft).
- The eardrum is gently lifted, and the graft is placed to fix the perforation. Depending on each patient’s condition, the placement of the graft may vary:
- Underlay: Graft is placed under the eardrum and is the most common option
- Inlay: Graft is plugged into the hole in the eardrum
- Overlay: Graft is placed on top of the eardrum
- Once the hole is repaired, the surgeon will pack the external ear canal with a soft, sponge-like gel foam and close the incision.
- Lastly, a pressure bandage may be wrapped over the ear around the patient’s head to help with healing. This can be removed a few hours after the surgery.
The entire procedure is expected to last between 1.5 to 2.5 hours.
After the Surgery
Initially after the surgery, patients may not be able to fully utilise their treated ear and might experience some discomfort. During the postoperative recovery period, patients can expect to:
- Make a follow-up visit one week after the surgery for a checkup and removal of sutures. Scars are usually barely visible due to their placement and size.
- Return for a second follow-up the following week to have the sponge inside the ear canal removed. Hearing may be impaired while the sponge is in place.
- Apply antibiotic ear drops as prescribed.
- Keep the ear strictly dry to prevent infection.
- Avoid swimming, popping the ears, blowing the nose, or pinching the nose when sneezing, as these actions may affect the eardrum.
- Avoid air travel until advised by the surgeon.
The Benefits of Myringoplasty
- Reduced Risk of Infections: The repair of eardrum perforation would prevent bacteria, dirt or water from entering the middle ear that could cause an infection.
- Restored Hearing: Most patients who undergo myringoplasty reported a restoration of their hearing ability.
- Reduced Risk of Language Delay: In young children, a perforated eardrum could cause hearing loss that could potentially result in language delays.
What is the Success Rate of Myringoplasty?
The success rate of myringoplasty varies according to the individual but is generally high. Most ENT surgeons successfully close the perforation in the eardrum on the first attempt.
To ensure optimal treatment and recovery, make sure you seek an experienced ear specialist for a Myringoplasty. You can schedule an appointment with our ENT surgeon, Dr Ker Liang, for an initial consultation at Aglow ENT Centre.
What are the Potential Risks and Complications of Myringoplasty?
Possible side effects of myringoplasty include temporary hearing loss, tinnitus (ringing in the ears) and blocked sensation in the ears during recovery. There is also a small risk of infection, which may impair healing. However, serious complications are rare. Most patients do not experience significant side effects. If you experience discomfort from a potential allergic reaction or infection post-surgery, contact your ENT specialist for prompt care.
When is a Myringoplasty Necessary?
When a hole in the eardrum is left untreated, that leaves room for bacteria or substances to enter. This could subsequently cause frequent ear infections, middle ear cysts (cholesteatoma), or even escalate to permanent hearing loss.
Particularly for patients with the following conditions, a myringoplasty may be necessary to resolve their eardrum problem:
- Perforated eardrums that have failed to heal or are unable to close on their own or upon medication within three months
- Chronic or recurring ear infections
- Hearing loss due to a ruptured eardrum
Without a proper evaluation and diagnosis by a medical professional, you may not be aware of an eardrum perforation. However, the following symptoms could indicate such an issue and warrant a prompt visit to an ENT specialist as soon as possible:
- A sudden, sharp pain in the affected ear that may resolve quickly
- Impaired or loss of hearing in the affected ear
- Ringing or buzzing sounds (tinnitus) in the ear
- Ear discharge, which could be clear, bloody, or pus-like
- Vertigo or a spinning sensation
- Nausea or vomiting, particularly if the inner ear is impacted
You can schedule a consultation with Dr Ker Liang, an experienced ENT specialist at Aglow ENT Centre for your ear, nose, or throat symptoms. Dr Ker Liang sees adults and children for general ENT conditions and provides comprehensive management in a broad range of Ear, Nose, and Throat, as well as Head and Neck conditions. She is able to perform a Myringoplasty for patients who require the perforated eardrum treatment.
Frequently Asked Questions
Can I sit on an aeroplane after Myringoplasty?
You cannot travel by plane until your specialist advises you otherwise after a myringoplasty.
How rare is a hole in the eardrum?
A hole in the eardrum is a relatively common condition in both adults and children alike.
Can you blow your nose after Myringoplasty?
It is best to avoid blowing your nose after a Myringoplasty, as the pressure could affect the repaired eardrum.
Which side should I sleep on if I have a hole in my ear?
The side you sleep on does not affect the perforation in your ear. However, you should avoid sleeping on the operated side after a Myringoplasty.
Medical Teaching
Assistant Professor Ker Liang has a passion for teaching and is an Assistant Professor with NUS Yong Loo Lin School of Medicine (YLLSOM). As the NUS-NUH Otolaryngology Department Undergraduate Medical Director, Dr Ker Liang supervises the training of medical students from YLLSOM, NUS. She is actively involved
in the training of postgraduate junior doctors and residents in the Head and Neck Surgery department. She was conferred with an Undergraduate Teaching Award by the National University Health System in 2016 for her outstanding efforts as an Otolaryngology educator.
Medical Teaching
Assistant Professor Ker Liang has a passion for teaching and is an Assistant Professor with NUS Yong Loo Lin School of Medicine (YLLSOM). As the NUS-NUH Otolaryngology Department Undergraduate Medical Director, Dr Ker Liang supervises the training of medical students from YLLSOM, NUS. She is actively involved
in the training of postgraduate junior doctors and residents in the Head and Neck Surgery department. She was conferred with an Undergraduate Teaching Award by the National University Health System in 2016 for her outstanding efforts as an Otolaryngology educator.
