The eardrum is a very important organ for hearing. It is a small membrane present at the end of the ear canal that collects sounds that enter the ear. The sound waves vibrate the eardrum and are then transmitted to the ossicles (bones of hearing). The eardrum also protects the middle ear from debris and bacteria. 

Seeing the functionality of the eardrum, you can understand that if perforation occurs in the eardrum, it can lead to permanent hearing loss. To prevent that from happening, it is crucial to get the perforated eardrum repaired by an ENT specialist. 

According to a survey done by NCBI in the rural population of India, more than 35.65% of people are suffering from ear diseases. And the most common ear disease was the perforated eardrum. 

So, today, we will focus on the methods that are generally used for the treatment or repair of perforated eardrums. Alongside, you will also learn about the risks associated with the repair methods and what you can do to get the best results. 

What are the methods used for perforated eardrum repair?

To determine the best method to repair the perforated eardrums, the ENT surgeon performs several tests. These tests include an otoscope exam, an audiology exam, a fluid sample, and a tympanometry test. Through these specialized tests, the ENT surgeon will determine the right approach to fix the rupture or hole in the eardrum. 

The following methods are effective in treating perforated eardrum:

• Antibiotics 

This is a medical treatment method that helps to clear up the infection in the ear that might have led to perforation. Taking antibiotics will also help to protect the eardrum against new infections. The doctor may prescribe oral antibiotics, medicated ear drops, or both. 

However, this method is only effective for mild infection and perforation. And it is not a permanent repair method. You will still need patches or surgical treatment to repair the hole in the membrane. 

• Patching 

In many cases, the perforation in the eardrum often heals on its own. But if that doesn’t happen, the doctor will suggest patching. This repair method involves using a medicated paper patch. The patch is placed over the hole in the membrane. It encourages the membrane to grow back and the perforation is fixed. 

• Surgery

In some cases, the ENT surgeon will recommend that you undergo surgery to patch the hole in the eardrum. There are three surgical techniques available for eardrum repair:

Myringoplasty

Also known as Type 1 tympanoplasty, this procedure involves placing a patch over the hole with a gel or using a paper-like tissue. The procedure takes only about 15 to 30 minutes and can be done easily under local anesthesia. 

Tympanoplasty 

Tympanoplasty is a surgical procedure that can be used for the repair of mild to moderate cases of perforation. This surgery is performed under general anesthesia which means you will be unconscious during the procedure. 

The different types of tympanoplasty are:

• Type 1 is performed on the tympanic membrane alone after ensuring that the middle ear has no problem. This procedure is synonymous with myringoplasty. 
• Type 2 is performed to repair the tympanic membrane even though slight defects are present in the middle ear. 
• Type 3 procedure involves removal of the ossicles ad epitympanum due to significant defects in the malleus and incus. The tympanic membrane is then repaired and directly connected to the head of the stapes so that you can hear properly. 
• Type 4 tympanoplasty is the repair method that is done when the stapes footplate is movable but crura are missing. After this procedure, the resulting middle ear will consist of only a Eustachian tube and hypotympanum after the tympanic membrane is patched. 
• Type 5 tympanoplasty involves complete repair of the fixed stapes footplate. 

Ossiculoplasty 

An ossiculoplasty is the procedure performed when the ear infection has reached the bones of the middle ear through the hole or perforation. If the ear infection reaches the bones of the middle ear, the bones need to be replaced by using bones from a donor or by prosthetic devices. 

What happens during the eardrum repair procedure?

The repair procedure of the eardrum is carried out after putting you under anesthesia. So, you’ll be asleep during the surgery. It involves:

• A small incision in front or behind the ear. Only a small tissue is removed from under the skin that can be easily covered by your hair. 
• Small surgical instruments are used to patch up the hole in the eardrum with the help of the tissue taken from behind the ear. It can be done directly through your ear canal or by making a small cut next to your ear. 
• After placing the patch, dressing is used to hold the patch in place and prevent water and germs from entering the ear. The patch stays in place for about 2 to 3 weeks. 
• Then a cotton wool padding is put over the ear and held by bandages. The incision(s) in front or behind the ear will also be closed with stitches (if any).

The surgery takes about 40 to 60 minutes and is performed on an outpatient basis. You are sent back home on the day after few hours. 

What are the risks associated with surgical treatment of perforated eardrums?

Similar to all surgical procedures, the perforated eardrum repair also has some risks associated with it. These risks include:

• Taste disturbance as the taste nerve runs very close to the eardrum and often needs to be cut during the repair procedure. Even though the nerve is reconnected, the patient may experience temporary or permanent loss in taste. 
• Dizziness is common after eardrum repair surgery but in some cases, it may persist for longer due to which you may have to visit the doctor again. 
• Hearing loss is also a possible complication of eardrum repair surgery. It happens if the inner ear is damaged during the procedure. 
• Tinnitus or ringing sounds also occur in the ear even after the eardrum is repaired. As your hearing gets worse, the ringing sound will also get worse. 
• Facial paralysis can also occur while the surgeon is repairing the hole in the eardrum. The nerve of the face muscle runs through the ear which can get damaged and leave your face paralyzed partially or completely. 

To ensure that the risks are mitigated and there are no post-surgery complications after undergoing surgery, you need to contact a reliable and experienced ENT surgeon. He/she will know how to carry out the procedure with maximum safety and provide the best results. 

The Bottom Line 

If you are suffering due to a perforated eardrum and need to get it repaired, you can totally rely on expert ENT surgeons at Pristyn Care. Pristyn Care has a dedicated team of ENT surgeons with more than 8 years of experience in performing eardrum repair surgery with a success rate of more than 90%. Book an appointment with our specialists and learn more about the repair procedure in detail.