A hole in the ear drum (perforation) may be caused by an infection or injury to the ear; usually a perforation will heal on its own in time but sometimes it can become ‘chronic’ and cause recurrent infections and so need surgical repair. To diagnose a perforation of the ear drum a clear view of the tympanic membrane is needed which often requires an examination with the microscope. A hearing test is necessary to assess the hearing level as sometimes there can also be some damage to the ossicles (three small bones) in the middle ear.
As most perforations heal on their own surgery is rarely the immediate treatment but it is important to keep the ear dry to try to prevent further infections. If it fails to heal surgical repair of the perforation may be carried out usually under a general anaesthetic (myringoplasty). Sometimes the surgery can be carried out down the ear canal with only a small incision above the ear to take the graft that is used to repair the drum; the graft may be a thin layer of fibrous tissue or cartilage which are both incorporated into the ear drum and achieve good success rates. If there is some damage to the ossicles this may be repaired at the same time. Occasionally a perforation occurs in children and may be repaired around the age of 9years old.
Once the ear drum has been successfully repaired there should be no further infections of the ear.
Myringoplasty Information
