Eardrum surgery

Eardrum surgery is also known as a myringoplasty, or sometimes a tympanoplasty. A perforated eardrum can be caused by an ear infection, an injury to your ear or previous surgery on your ear.

Why have eardrum repair surgery?

Most of the time, a perforated eardrum will heal by itself. But if it doesn’t, it can go on to cause repeated infections of your middle ear, particularly after you get your ear wet. It can start to affect your hearing too.

Your doctor may recommend surgery if your eardrum perforation hasn’t healed after a certain period of time – usually at least a couple of months. This is more likely if you’ve had a middle ear infection that’s lasted a long time or keeps coming back.

Some people are also found to have a growth of skin cells inside their ear, called a cholesteatoma. This can lead to infections and damage to your ear. A cholesteatoma can be removed at the same time as eardrum surgery

Having surgery can prevent water getting into your ear and further infections. It may also improve any hearing loss. It’s your choice whether to go ahead with surgery. A perforated eardrum doesn’t always cause problems, and some people prefer to wait and see whether it heals by itself.

How to get eardrum surgery

You can have eardrum surgery privately or on the NHS. Either way, you’ll need a referral from a GP to see an ear, nose and throat (ENT) specialist. They will assess you and advise whether surgery would be beneficial. Many private health care providers offer rapid access for eardrum surgery. Waiting times for eardrum surgery in the NHS will vary depending on where you live, but are usually many months – and may be much longer currently as a result of the COVID-19 pandemic.

The surgery to repair your eardrum is likely to be similar, whether it’s in the NHS or the private sector.

Preparing for eardrum surgery

Your doctor will want to carry out some investigations before surgery, including a hearing test. This will help to decide the type of procedure you need. Your doctor may also need to remove any earwax to be able to view your eardrum clearly.

It’s important to make sure you’re in the best possible health before surgery. If you smoke, it’s best to stop before the operation as this can affect recovery and success of the surgery. It’s also good to lose any excess weight if possible, and to maintain a healthy diet. Try to keep physically active before your operation too.

Eardrum surgery is usually carried out under general anaesthesia, which means you’ll be asleep during the procedure. You’ll need to stop eating and drinking before a general anaesthetic – your doctor will tell you exactly when. The surgery is usually done as a day-case procedure, which means you go home on the same day.

What happens during eardrum surgery?

Your ENT surgeon will usually reach your eardrum by making a cut behind your ear, or just above the opening to your ear. Sometimes they may do the surgery through your ear canal. They’ll take a patch of tissue, called a graft, from underneath your skin. They’ll usually do the repair by lifting up your ear drum and placing the graft under the small hole in your eardrum. Your surgeon will place dressings inside your ear to hold the graft in place. The small cut in your skin will be closed with a stitch.

When it’s just your eardrum that’s repaired, it’s called a myringoplasty or tympanoplasty. Sometimes, your surgeon may also need to fix the tiny bones in your middle ear, as well as your eardrum. This is sometimes called an ossiculoplasty.

How long does it take to recover from eardrum surgery and what should you expect afterwards?

You’ll be monitored in hospital for a few hours while you recover from the anaesthetic. You’ll usually be able to go home as soon as you feel ready, but you’ll need someone who can take you and stay with you overnight.

You may have a head bandage after the operation. Your surgeon may remove this before you go home, or you may need to keep it on overnight. You may also have cotton wool inside your ear to collect any discharge during the healing process. You should change this every day if so.

If you have stitches that aren’t dissolvable, you’ll need to have them removed after a week or so. The dressings deeper inside your ear will need to be kept in place for around two weeks, and you’ll usually need a follow-up appointment with your surgeon to have these removed. Some surgeons put in dissolving dressings that don’t need removal. You’ll still be able to wash your hair or shower while you have the dressings in, but you should put a cotton ball covered with Vaseline in your ear to keep it dry. You’ll usually need to keep the wound dry for at least a week, but your surgeon will advise you.

You’ll usually need to take at least a week off school or work as recovery time from eardrum surgery. A follow-up appointment will be arranged for you, so your doctor can check whether your eardrum has healed properly. They’ll also assess your hearing. In the meantime, there are certain activities you should avoid – including flying, swimming and strenuous sports. This is usually for at least 6 weeks. Avoid blowing your nose too hard, as this can damage your eardrum while it heals. You also shouldn’t try to unblock your ears by pinching your nose and blowing, as the pressure can blow the graft off.

Eardrum surgery isn’t usually very painful, but if you need it, you can take standard over-the-counter painkillers after the operation.

Potential complications of eardrum surgery

All surgical procedures carry a certain amount of risk. Your surgeon will discuss this with you before the procedure. Some of the most common complications of eardrum surgery include the following:

• The graft failing and the hole in your eardrum coming back.
• Dizziness – this is common for a few hours after surgery, but sometimes can last for longer.
• Hearing loss, if parts of your ear are damaged.
• Tinnitus (ringing or buzzing in your ear).
• Changes in taste – this can be temporary but is sometimes permanent.
• Weakness or paralysis of your facial muscles (permanent paralysis is very rare).

The risks of these complications are generally very low, and the surgery usually works well. Up to 9 in 10 people have a successful procedure. This can vary depending on the technique used, your surgeon and your own individual circumstances, so do check this with your own surgeon.

How much does eardrum repair surgery cost?

Eardrum surgery is often available through private medical insurance. Check with your insurer whether they will cover it.

You can also choose to self-fund eardrum surgery. Typically, an initial consultation with the surgeon will cost between £175 and £220. Eardrum surgery costs in the UK vary depending on where you live. If you move forwards with the procedure, you’ll be offered one of the following.

• An all-inclusive ‘package price’, where you know the full costs before undergoing treatment. Not all consultants and hospitals offer this.
• A ‘fee-per-service’ arrangement, where you receive different invoices from the surgeon, the anaesthetist and the hospital. You often won’t know the full costs until you receive the invoices.

For more information, you can read our guide on self-pay.

References

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• You and your anaesthetic. Royal College of Anaesthetists, www.rcoa.ac.uk, February 2020.
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