Tympanic Membrane Perforation - Dubai ENT Clinic 

Tympanic Membrane Perforation or Ear Drum Hole

Tympanic membrane is a thin one cm squire membrane that separates the middle ear from the external ear. The ear drum is composed of 3 layers outer is skin and inner is mucosa and fibrous tissue in between. The ear drum transfers the sound via the ear bones (ossicles) to the inner ear, and protects the middle ear from the external pollution and high sounds. If this membrane is perforated for any reasons, it will affect the middle ear function and reduce the hearing function.

Causes of Tympanic Membrane Perforation

• The most cause of eardrum perforation is the exacerbation of middle ear infection.
• The pus will perforate the drum by pressure, mostly this hole will cure spontaneously during one month but sometimes, it will be a persistent hole.
• Other causes are exposure to high sound pressure, atmospheric pressure, or direct trauma to the eardrum.

 How the myringoplasty can be done:

Small perforation of tympanic membrane can be healed spontaneously without surgical intervention, by protecting the ear from water, or by paper patch over fresh perforation.

But the term myringoplasty: describe a surgical procedure for closing the ear drum hole , skin incision should be done back , front  the ear, or trans ear canal sometimes.

Several type of grafts can be used:

1. Homograft:
   • Fatty tissue
   • Cartilages
   • Perichondrium
   • Periosteum
2. Allograft:
3. Artificial
   
   

Who are the candidates for myringoplasty?

1. Age older than six years
2. Dry ear, free from infection
3. No contraindications for general anaesthesia
4. Good eustachian tube function
5. Social – presence of the tympanic membrane perforation will affect the lifestyle, especially water activities (swimming).
6. Hearing loss

 Recommendation Before Myringoplasty

• Generally, patient should be fit for general anaesthesia (sometimes, we can use local anaesthesia).
• No active infection, fever, or upper respiratory tract infection.
• No chronic debilitating diseases: DM, HIV
• at least six weeks, free from discharge or infection.
• It is preferable to establish the nasal breathing before the operation (nasal septum deviation, nasal polyps, or turbinate hypertrophy).
• Controlling the allergic rhinitis.
• Sleep well the night before the operation.
• Avoid smoking for 1-2 weeks.

 What to expect after the operation?

• You will have firm bandage around the affected ear for up to 24 hours.
• There is a pack in the ear which may affect the hearing.
• You have to stay in the hospital overnight. You can be discharged home the next day.
• Stitch will be removed after one week.
• Ear pack will be removed 2-3 weeks in the OPD.
• Washing of hair should be performed carefully not to make the ear wet. Having the ear wet can increase the possibility of infection.
• You can return to work or school after one week.
• Mild analgesic (Paracetamol or Ibuprofen) can control the pain for several days.
• There is a 10% failure rate of the operation. Another operation then may be needed.
• Travelling by airplane is not allowed for three months.

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