Myringoplasty

Introduction

Myringoplasty is a procedure used to repair a hole in the ear drum.

Indications

A myringoplasty will usually be offered in situations where there is a hole in the eardrum accompanied by any of:

  • Hearing loss.
  • Recurrent infection or discharge.
  • As part of a cholesteatoma procedure.

Preoperative Instructions

It is important to keep the ear clean and dry prior to surgery.

Usually this procedure is completed under a general anaesthetic. You should follow the advice of the Anaesthetist and admitting hospital prior to surgery. Any queries should be directed to the Anaesthetist, admitting hospital or Dr Morrissey and his staff.

Risks

Like any surgery, myringoplasty has general risks including:

  • Pain.
  • Bleeding.
  • Infection.
  • Failure of the procedure / Residual perforation.
  • Scarring.

Specific risks related to the ear include;

  • Failure to improve hearing or worsening of hearing.
  • Facial nerve injury.
  • Loss of taste.
  • Vertigo / Dizziness.
  • Cholesteatoma.

Treatment Alternatives

A perforated ear drum is not a life threating issue and consequently can be observed in some circumstances. Hearing loss may be overcome with the use of hearing aids, while infections can be treated with antibiotics and ear cleaning.

If a myringoplasty is an option for you or your loved one Dr Morrissey can discuss your personal circumstances and the options available.

Procedure

There are a number of approaches to this procedure which will be individually tailored to your circumstances.

Depending upon where the hole is in the eardrum, an incision will be made either in the ear canal or behind the ear. Suitable graft material will be sourced from the cartilage or adjacent tissues of the ear. The graft is then placed across the hole and secured in place with absorbable foam. Given the size of the space it is not possible to suture the graft in position.

Once the graft is placed, absorbable or non-absorbable packs may be placed in the ear canal, incisions are closed, and a dressing is applied to the ear.

Postoperative Instructions

Return to Normal Activities

Recovery from Myringoplasty takes 1-2 weeks. You may choose to keep your child away from day-care, kindergarten and school for 3-4 days following surgery and adults will need 1 week off work.

General activities can be resumed as you feel up to it.

Ear Care

After leaving hospital, a small cotton ball can be placed in the bowl of the ear to absorb any discharge. It is common to have blood stained ooze from the ear following the operation.

14 days after the operation you may commence using the prescribed eardrops. These help dissolve any packing material within the ear canal.

The graft following Myringoplasty is held in place by packing and pressure only. Avoid sneezing, nose blowing, flying, diving and heavy straining to prevent the graft being dislodged. If you must sneeze or cough, then do so through an open mouth.

Most of the above can be recommenced 6 weeks following surgery but please ask Dr Morrissey if you have any queries.

Wound Care

When an incision has been made behind the ear, there will usually be a dressing in place. This can be removed after 5 days. Thereafter Chlorsig ointment can be applied 3 times a day until it is healed.

Where the incision is at the front of the ear, Chlorsig ointment can be applied straight away post-op, 3 times daily.

In both cases, stitches are usually absorbable and do not require removal.

Pain relief

Most people experience mild ear discomfort following surgery.  Paracetamol (Panadol) or Ibuprofen (Nurofen) is usually all that is required. Please follow dosage instructions as advised by the manufacturer.

Should pain relief requirements exceed this, please contact Dr Morrissey.

Antibiotics

Eardrops may be prescribed following surgery. Please take as directed.

Diet

There are no restrictions on diet.

Fever

It is common to have a mild fever for the first 24hrs after the operation.  Please call Dr Morrissey’s rooms if there is a persistent fever greater than 38.5°C.

Water Precautions

Please keep the ear dry following surgery as water in the ear increases the risk of infection and reduces the chance of a successful operation.

Showering should be done by placing cotton wool coated in Vaseline into the entrance of the ear canal and using a bathing cap. To wash your hair, try to do so over a sink with the aid of another person.

Should water inadvertently enter the ear, dry the ear with a warm hairdryer to prevent water pooling in the ear canal.

Follow Up Appointment

Please make an appointment 3 weeks after surgery.

How to contact Dr Morrissey

For non-emergency issues please call (07) 4646 4275. for further instructions.

Dr Morrissey shares ‘on-call’ arrangements with other ENT surgeons and one is usually available to answer questions. The “on-call’ ENT surgeon can be reached via the ENT registrar at the Toowoomba Hospital on (07) 4616 6000.

Should your concerns not be addressed via a phone call please present to your nearest Emergency Department.

In the event of an Emergency call 000 or attend the nearest Emergency Department.

Related Information

Adult Hearing Problems
Ear Infections
Kids Hearing Problems