Tympanic Membrane Perforation

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A tympanic membrane perforation is essentially a hole in the eardrum, which can result from ear infections, injury, and previous surgery such as ventilation tube placement.  In addition to hearing loss, eardrum perforations can result in ear infection and drainage.  The infection is usually treated with antibiotic ear drops.  Most patients will need to keep water out of the ear with ear plugs or cotton ball with Vaseline.

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How is Tympanic Membrane Perforation Treated?

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If the perforation is very small, an otolaryngologist may choose to observe the perforation over time to see if it will close spontaneously. Most eardrum perforations heal on their own within weeks of rupture, although some may take several months to heal. During the healing process the ear must be protected from water and trauma.  Working with a microscope, your doctor may touch the edges of the eardrum with a chemical to stimulate growth and then place a thin paper patch on the eardrum. Usually with closure of the tympanic membrane, hearing is improved. Several applications of a patch may be required before the perforation closes completely. If your physician feels that a paper patch will not provide prompt or adequate closure of the hole in the eardrum, or if paper patching does not help, surgery may be required.

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A tympanic membrane perforation is usually treated with a surgical repair called a tympanoplasty. The procedure is a relatively short outpatient surgery that is performed under local or general anesthesia.  The surgery is performed through the ear canal or through an incision behind the ear. The hole in the eardrum is repaired using the patient’s own tissue, called fascia.  In some cases, the hearing bones (ossicles) are damaged by previous infection or trauma and can usually be repaired at the same time.

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Antibiotic eardrops are used in the ear after surgery.  Regular activities are started the next day. Patients are typically seen at one and three weeks after surgery to ensure proper healing.  A hearing test is obtained one to two months after surgery.

Hearing aids can be helpful for patients who desire improved hearing function but who do not desire surgical treatment.

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