Tympanic Membrane Perforations

Perforations of the eardrum (also known as the tympanic membrane) are quite common.  First, many perforations of the tympanic are uncomplicated and do not cause frequent infections. However, with water exposure, most perforations will cause frequent bouts of a draining ear. Also, perforations can cause hearing loss but this depends on the location and the size of the hole.

The cause of the perforation should also be taken into account. Patients with persistent Eustachian tube dysfunction, for example, might demonstrate a good surgical result initially with continued retraction and possible re-perforation of the newly closed drum. This should be discussed in greater detail with every patient and an individual decision should be made.

Once surgical closure has been decided, several techniques are available. For very small perforations, a so called myringoplasty procedure may be employed. For larger holes in certain locations and without much scarring of the remaining drum, underlay techniques (underlay tympanoplasty) should be attempted. For larger holes with extensive scarring, overlay methods (lateral graft tympanoplasty) should be considered. Depending on the surgical technique, the success rates range from 80-90 percent. However, re-operations are sometimes necessary. Also, with additional erosion of the hearing bones, an ossiculoplasty might be necessary in order to restore the hearing apparatus. This may require a separate procedure, however.

Depending on the surgical technique, the success rates range from 80-90 percent. However, re-operations are sometimes necessary. Also, with additional damage to the hearing bones, an ossiculoplasty might be necessary in order to restore good hearing.