Myringoplasty

What you should know

• Myringoplasty, also called tympanoplasty type I, is surgery to fix a perforated tympanic membrane. A perforated tympanic membrane means there is a hole in your eardrum. You may need this surgery if you have chronic otorrhea, which is ear discharge that keeps coming back. A myringoplasty may also be done if you have hearing loss from the hole in your eardrum. During this surgery, caregivers may also need to remove a portion of the bone behind your ear. Removing bone may be done if you have had many past ear infections causing your bone to break down.
  
  
• Caregivers may or may not need to cut open your ear depending on where the hole is located. A graft is used to cover or fill the hole in your eardrum. The graft may be a piece of fascia (hard tissue that covers muscles), skin, fat, or cartilage or its covering. The graft may be taken from another area of your body through a small incision (cut). The graft may also be man-made, from a donor (another person), or an animal. Myringoplasty may help prevent water and germs from entering your inner ear. After your surgery, your hearing may improve and your risk of middle ear infections may be decreased.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• You may be allergic to the anesthesia used during your surgery. You may bleed more than expected, have pain, and you may get an infection. You may scar in the area your surgery was done, or where your graft was taken from. You may get blood clots and your eardrum may collapse. Nerves or areas near your inner ear or face may be damaged during surgery. If an incision was made in your skin to reach your eardrum, you may take longer to heal. You may develop adhesions (abnormal fibrous connections) in your inner ear or narrowing of your ear canal.
  
  
• You may have hearing loss, otorrhea (excess ear discharge), or myringitis (swelling of your eardrum) after your surgery. Your graft may fail causing you to have an open hole in your eardrum again. You may also develop a new hole in your eardrum after a few years and need another surgery. If you do not have the myringoplasty, the hole in your ear may get bigger. Your hearing loss may get worse and lead to permanent hearing loss. You may have chronic (regular) ear infections. Chronic ear infections may spread to your head, neck, and brain, and may cause death. Call your caregiver if you have questions about your surgery, medicines, or care.

Getting Ready

Before your surgery:

• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicines. Ask your caregiver if you need to start or stop using certain medicines before your surgery.
  
  
• Tell your caregiver if you have had other ear surgeries or nose problems in the past.
  
  
• Your caregiver will look inside your ear to see the size and location of your eardrum hole. He may check you for other ear, nose, or throat problems. You may need to have blood and urine tests and x-rays. You may also need hearing tests, such as pure tone audiometry. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

Night before your surgery:

• Ask your caregiver about directions for eating and drinking.
  
  

Day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

Treatment

What will happen:

• You will be taken to the room where your surgery will be done. You will then be moved to a special bed or table. You will be given anesthesia medicine to keep you free from pain during your surgery. Caregivers may look inside your ear using a special scope. Your caregiver may need to remove any earwax present. Caregivers may make an incision behind your ear, or inside your ear. Caregivers may make the surface of your eardrum rough so the graft will attach better.
  
  
• Caregivers will check for other ear problems such as damaged bone. A graft is put underneath or over your eardrum to cover the hole. The graft may be secured using a special sponge containing gelatin or special glue. If fat is used as a graft, the fat is plugged into the hole of your eardrum. A bandage soaked in a special paste that prevents germ growth may be placed inside your ear. Caregivers will then close your incisions with stitches.

After your surgery:

You will be taken to a room where you will rest until you are awake. Do not get out of bed until your caregiver says it is OK. When caregivers see that you are having no problems, you may be able to go home. If you are staying at the hospital you may then be taken to your hospital room. You will be given antibiotics after your surgery to help prevent ear infections. You may have a bandage over or around your ear. The bandage will help keep your surgery area clean and dry, and help prevent infection.

Contact a caregiver if

• You cannot make it to your surgery.
  
  
• You get sick (a cold or the flu) or have a fever.

Seek Care Immediately if

• You have a headache that does not go away even after taking medicine.
  
  
• You have dizziness or loss of balance.
  
  
• You have nausea (upset stomach) or vomiting (throwing up).
  
  
• You have pain in your inner ear or behind your ear.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.