Eardrum repair surgery, known as “myringoplasty” in medicine, is an operation aimed at repairing the eardrum. This surgery is also referred to as a hearing correction surgery or hearing loss surgery in colloquial terms. Myringoplasty is often confused with tympanoplasty, which is performed in chronic problems related to the middle ear.

Tympanoplasty is performed to clean the inflammation present in the middle ear and the mastoid bone. In this operation, the damage to the eardrum and the middle ear is repaired, aiming to restore hearing loss. However, the surgery may also aim to repair only the damage to the eardrum, which is known as myringoplasty.

Sometimes, the patient may require both the repair of the eardrum and the removal of the infection that extends into the mastoid bone. In such cases, the surgical technique that used is called “tympanomastoidectomy,” which is a combined surgical procedure. The decision regarding which surgical technique to administer is made by your doctor based on a comprehensive examination and diagnostic tests.

Where is the Eardrum Located?

Patients undergoing eardrum surgery or those with eardrum-related damage may wonder where exactly the eardrum is located. The outer ear consists of the ear canal and the earlobe. The eardrum, on the other hand, is situated in the deeper parts of the ear canal, serving as a barrier between the outer and middle ear. The eardrum is quite thin and receives sound waves, causing vibrations on its surface. These vibrations contribute to the body’s hearing function.

Can Eardrum Perforation Affect Hearing?

The middle ear is the section behind the eardrum, which contains a space filled with air. A small canal called the Eustachian tube carries air from the back of the nose, in the nasal cavity, to this part of the ear. The Eustachian tube has a vital function—it equalizes the pressure of the air in the middle ear cavity with the atmospheric pressure. Sound waves, which enable hearing, are transmitted from the eardrum to the inner ear through the three small bones known as the hammer, anvil, and stirrup. This process stimulates the nerves that transmit sound signals to the brain. Hearing function is accomplished through this intricate process.

Any perforation in the eardrum disrupts this entire process. When the eardrum is perforated, it can cause significant damage to the inner ear. These damages disrupt the functioning of the hearing process. With surgery, the eardrum is repaired using tissue, aiming to restore the compromised hearing function of the system.

What are the Symptoms of Torn or Perforated Eardrum?

It is not always easy to detect a torn or perforated eardrum. While there are certain symptoms, they may not always be clearly perceived by the patient. Some examples of these symptoms are:

  • Pain in the ear area
  • Fluid discharge from the ear
  • Hearing loss
  • Numbness around the ear and surrounding areas
  • Hearing strange noises
  • High body temperature
  • Ringing in the ear (tinnitus)
  • Dizziness
  • Nausea
  • Difficulty in maintaining balance

Can Torn or Perforated Eardrum be Treated without Surgery?

One of the remarkable characteristics of the eardrum is its ability to self-heal. However, this natural healing process only applies to small holes, tears, or damages. Therefore, the size of the tear in the eardrum is crucial. If the perforation is large, it cannot be treated with medication or non-surgical methods such as laser treatments. Surgical intervention is necessary for repair in such cases.

How is Myringoplasty Performed?

When making the decision for a myringoplasty, the doctor considers several factors, including:

  • No history of middle ear infection within the past month.
  • Conductive type of hearing loss, not exceeding 40 decibels.
  • Absence of middle ear pathologies in the patient.
  • Of course, comprehensive examinations and tests are conducted prior to the operation to determine the most suitable approach for myringoplasty.

There are generally three different approaches to myringoplasty:

Postauricular Approach: This approach is chosen when the entire edges of the perforation cannot be accessed due to exostosis. It is commonly used for anterior quadrant perforations of the tympanic membrane.

Endaural Approach: This surgical technique involves an incision made through the external auditory canal, joining the incision between the tragus and helix. The endaural approach is often performed when the cartilaginous part of the external auditory canal is narrow.

Transcanal Approach: In this approach, the operation is performed through the external auditory canal. However, for this technique to be applicable, the entire edges of the perforation must be visible through the external auditory canal. It is particularly preferred for posterior quadrant perforations.

What are the Stages of Tympanic Membrane Repair?

The process of tympanic membrane repair involves the following stages:

  • The structure of the ear canal, the location of the hole or tear in the eardrum, the patient’s overall health, age, and the need for any intervention in the mastoid bone are considered in the surgical planning.
  • General anesthesia is administered, and the operation begins.
  • Depending on the chosen technique, an incision is made inside the ear canal, behind the ear, or in the front part of the auricle, or access to the eardrum is obtained through the middle ear.
  • The repair of the eardrum is performed using either the temporalis fascia graft technique or other graft techniques.
  • Sutures are applied to the incision site, and the operation is completed.

Are Stitches Used in Tympanoplasty?

Firstly, it should be noted that tympanoplasty can be performed with or without an incision on the outer part of the ear. The decision to make an incision or not depends on the chosen surgical technique. If no incision is made and the perforation is accessed through the hole in the external ear canal, the repair is performed without the need for stitching. However, if an incision is made in the outer ear, stitches will be necessary for tissue healing.

At What Ages is Tympanoplasty Performed?

There is no upper age limit for tympanoplasty. Eardrum damage can occur at any age due to various reasons. As long as there are no health issues that would prevent surgery, eardrum repair can be performed on patients of all ages. It is difficult to specify a lower age limit as well. If the hearing loss due to eardrum damage is minimal, surgery can be performed after the age of 12. However, if the hearing loss is significant, the surgery can be performed at earlier ages without waiting until 12. You can consult your doctor for a definitive answer based on examinations and tests.

Is Tympanoplasty Difficult?

From the patients’ perspective, tympanoplasty is not a challenging process. Since the surgery is performed under general anesthesia, there is no pain or discomfort felt in the ear or facial area during the operation. Therefore, there is no need to worry about the miringoplasty process. After the surgery, some precautions need to be taken, and patients may experience mild discomfort. Patients should focus on following the doctor’s recommendations and warnings for a smooth recovery process.

What Happens If Tympanoplasty is Not Performed?

Tympanoplasty is not always necessary to be performed urgently. The eardrum has the potential to heal spontaneously within 4-7 days. If there is significant tissue loss, the possibility of spontaneous healing diminishes, and surgery is performed. If the surgery is not performed, significant problems such as infections can occur. Patients may experience balance problems, sudden dizziness, and other issues.

How Much Does Tympanoplasty Cost?

The cost of tympanoplasty can vary depending on factors such as the technique used, the surgeon’s experience, the type of graft used, or the material chosen for eardrum repair. Therefore, before providing a price, a comprehensive examination should be conducted, and the surgery should be planned in detail. Afterwards, the price can be determined and communicated to you.

How Long Does Tympanoplasty Take?

It should be noted that the duration of the surgery can vary. The chosen approach for tympanoplasty and the method of repairing the eardrum are factors that can influence the length of the operation. Typically, the surgery takes between 1 to 3 hours.

Postoperative Period of Tympanoplasty

Patients may wonder what to expect during the recovery period after tympanoplasty. Here is some information about the postoperative process:

After the operation, a bandage is placed on the ear, and it should remain in place for at least 24 hours.

The ear canal packing, if used, is typically removed after 1 to 3 weeks.

Mild pain is expected after the surgery. It is important to only use painkillers prescribed by the doctor and avoid taking random pain medication or using any unapproved methods.

A slight discharge from the ear is normal and can sometimes be bloody. If there is excessive bleeding, it is crucial to inform the doctor.

The incision in the ear area may cause mild numbness, which will resolve on its own over time.

A special material is placed to keep the repaired eardrum in position. This material does not need to be removed as it dissolves naturally within the body.

It is important to strictly follow the doctor’s recommendations and instructions for a smooth recovery process.

Postoperative Care Instructions for Tympanoplasty Patients All patients undergoing tympanoplasty should pay attention to certain aspects after the operation. The seamless healing process depends not only on the surgical intervention but also on the patients’ adherence to these guidelines.

Here are some examples of what to consider after tympanoplasty:

  • For at least one week after the surgery, the head should be elevated during sleep, and patients should use two pillows.
  • Careful attention should be given to nutrition, and for one week, patients should consume only soft, fibrous, and liquid foods.
  • Avoid eating hard-to-chew foods and refrain from habits like biting pens or eyeglass stems.
  • It is important to avoid actions such as coughing and straining.
  • Physical exertion, exercise, and sports should be avoided for one month.
  • Water sports should be avoided for at least 6 months.
  • Heavy lifting should be avoided for 15-20 days after the operation.
  • Preventing water from entering the ear is crucial. Earplugs available at pharmacies can be used during bathing or in rainy weather.
  • Protection against flu-like infections is essential for one month.
  • The ear should not be subjected to any kind of impact.
  • Avoid air travel until the specified time recommended by the doctor due to the potential harmful effects of sudden pressure changes.
  • Traveling by road is prohibited for 4 to 6 months due to the potential pressure changes caused by changes in altitude.
  • Massaging or rubbing the ear should be avoided after the operation.
  • Stay away from loud environments until the healing is complete.
  • Avoid using a hairdryer near the ear area.
  • Strictly follow the doctor’s instructions regarding prescribed medications and ear drops. Use them continuously and as directed.
  • Until the stitches are removed, pay attention to the incision sites in the ear area and maintain proper hygiene. After showering, gently dry the area and prevent it from remaining wet.
  • Avoid hot environments such as steam baths, solariums, or saunas for the first month. Swimming in the sea or pool can pose an infection risk, so it is important to stay away from them.
  • Avoid wearing accessories such as earrings or piercings for several months.

What Are the Risks of Tympanoplasty (Eardrum Surgery)?

Surgical procedures, including tympanoplasty or eardrum surgery, carry various risks and potential side effects. Here is some information regarding the risks and side effects:

  • Infection
  • Bleeding
  • Dizziness
  • Disturbances in the sense of taste
  • Mild pain
  • Allergic reactions
  • Swelling
  • Bruising
  • Risks associated with anesthesia

When is the Sense of Hearing Regained After Tympanoplasty?

Patients should not expect to immediately regain their hearing after tympanoplasty. Special materials are placed in the ear during the surgery, which can cause a feeling of blockage in the ear. These materials, which dissolve over time, prevent proper hearing. The duration varies for each patient but it typically lasts around 20 days. Afterward, there may be some mild hearing problems. In brief, it takes approximately 2-3 months for full hearing recovery.

Post-Tympanoplasty Care

Patients who undergo tympanoplasty do not usually have significant difficulties with post-operative care. While certain factors require attention, post-tympanoplasty care does not greatly disrupt patients’ daily lives. Therefore, there is no need to worry about post-operative care.

First and foremost, patients can continue their daily activities with certain restrictions just one day after the operation, provided that no complications develop, and they feel well. If the operation goes smoothly without complications, and the patient feels well, they can be discharged. Consequently, there is no need to rest in a clinical environment for days. Patients do not need to stay away from work for an extended period either.

Hygiene is the most crucial aspect of post-operative care. Frequently touching the incision site after the operation can introduce bacteria and lead to infection. It is important not to touch or disturb the incision and suture area. Keeping the area clean and dry is of utmost importance. The fundamental requirement for post-tympanoplasty care is to keep the area clean and dry.

Before the discharge process, dressing is applied to the incision site. Sometimes, if prescribed by the doctor, patients may need to use corticosteroid-containing eardrops. It is important to use the drops at the specified intervals without neglecting them. The same applies to prescribed antibiotic usage. Antibiotics are used to prevent infection. Neglecting or not following the specified usage schedule can result in infection, which can lead to dangerous consequences.

When only the eardrum is involved, healing tends to occur more rapidly. However, in cases where additional interventions are performed along with eardrum surgery, occasional additional procedures like dressing changes may be necessary. Your doctor will inform you about these procedures before discharge. Paying attention to dressing procedures is a crucial step in post-operative care.

During the first days after the surgery, paying attention to nutrition is important for two reasons. Firstly, consuming soft and lukewarm foods prevents adverse effects on the incision site due to jaw movements. Secondly, it helps protect against respiratory infections, thereby avoiding actions such as sneezing and coughing. Maintaining a healthy and balanced diet, along with adequate water consumption, is essential for keeping the immune system strong. Materials such as ear bandages or tampons should not be removed by the patient before the specified duration.

Is Surgery Necessary for Every Torn Eardrum?

It is often assumed that immediate surgery is required when the eardrum is torn. However, eardrum surgery is not necessary for every tear. If the perforation in the eardrum is smaller than 2 mm, it may heal spontaneously with some waiting time. However, it is important to note that there should be no occurrence of inflammation during this waiting period. If inflammation is present, immediate action must be taken.

Hearing loss may not occur in simple eardrum tears. In such cases, the rate of hearing loss is around 30%. Therefore, these patients do not need surgery. However, even if there is a simple eardrum hole, a life-threatening situation may occur in case of cholestatoma. For this reason, the operation is necessary that the inflammation must be cleaned and the eardrum must be repaired.

Patients should leave the decision about surgery to the doctor. Complaints caused by rupture of the eardrum may be mild. However, your doctor may recommend surgical intervention as soon as possible. There is no link between the risks that may occur and the symptoms of ruptured eardrums. For this reason, the decision whether to have surgery or not should be made by the doctor.

Tips for Protecting the Eardrum

To protect the eardrum, it is important to avoid impacts to the ear. Blows to the ear can cause serious damage to the eardrum. Individuals who experience conditions such as nasal congestion, postnasal drip, or sinusitis should be cautious about air travel and avoid diving sports. Another cause of eardrum perforation is the entry of hot water into the ear. Therefore, it is important to be careful not to let water enter the ear while bathing. If a perforation occurs in the eardrum and spontaneous healing is expected, it is crucial to be even more careful in these situations, as a mistake during this process can prevent the eardrum from repairing itself.

Rupture of the Eardrum due to Impact

Slaps, punches, or strong blows to the ear are among the most common causes of eardrum ruptures. If the hole in the eardrum is not large, ruptures caused by ear impacts often heal on their own, without the need for surgery. However, it should be noted that not every patient experiences this outcome. If you feel symptoms indicating a rupture in the eardrum after an impact, it is beneficial to seek medical attention within the first 24 hours. Consulting an otolaryngologist promptly can enable simple interventions to ensure quick and proper healing. Therefore, it also increases the likelihood of receiving appropriate treatment.

What are the Causes of Eardrum Perforation?

The question of why the eardrum perforates is frequently discussed in the context of this surgery. The most prominent causes of eardrum perforation are usually infections or traumas. In general, the following factors can cause damage to the eardrum:

  • Impact to the ear
  • Fractures in the skull
  • Sudden pressure changes (barotrauma)
  • Rapid changes in cabin pressure during air travel
  • Sudden explosions
  • Entry of harmful fluids into the ear
  • Entry of excessively hot water into the ear
  • Use of cotton swabs or toothpicks
  • Infections

Sometimes, when the eardrum is ruptured, there may be a leakage of infected or bloody fluid from the ear. In such cases, patients tend to seek medical attention promptly. However, if the symptoms are mild, delayed medical consultation may occur. If the ruptured eardrum does not repair itself within a specific period, surgical intervention is necessary to facilitate repair.

Why is Treatment of the Eardrum Important?

It is important to note that the eardrum not only enables hearing but also plays a significant role in protecting the inner structure of the ear from the external environment. The eardrum is an anatomical barrier in the ear, preventing the entry of microbes, bacteria, and viruses from the outside. It also prevents water and dust from reaching the inner ear. If a hole in the eardrum remains unrepaired, numerous microbes can enter the inner ear, especially with water, and rapidly proliferate there.

The risk of hearing loss should not be overlooked either. An unrepaired eardrum not only causes hearing loss but also poses a serious risk for conditions such as dizziness, facial paralysis, brain abscess, or meningitis. Therefore, if the hole in the eardrum is larger than 2 mm or if it does not repair itself naturally, it is essential to undergo a myringoplasty operation as soon as possible.

How is the Eardrum Repaired?

In eardrum surgery, the patient’s own tissue can be used for the repair. The most commonly used tissue is the fascia of the temporal muscle. This fascia is easily obtainable because of its proximity to the surgical site. Other options include sterilized brain membrane