Eardrum repair (myringoplasty): what happens and what to expect

A hole in the eardrum can follow infection, injury or a grommet that has left a perforation. Some holes heal on their own and many cause no trouble. Repair is considered if the ear keeps discharging or becoming infected, or if you are tired of keeping it dry for swimming and showering.

ENT UK points out that repairing the drum alone does not usually lead to a great improvement in hearing, so the operation is not mainly a hearing operation. Alternatives include keeping the ear dry, using antibiotic drops for infections and trying a hearing aid when hearing loss is significant.

Your surgeon will examine the ear with a microscope and arrange a hearing test beforehand. ENT UK says smoking can reduce the success of the operation, so stopping before surgery helps. The ear should be free of active infection, so tell the team if it starts discharging shortly before your date.

Arrange around two weeks off work and someone to take you home, as general anaesthetic is used.

Dorset describes an operation of about an hour under full general anaesthetic. ENT UK explains that the surgeon uses a graft of skin or cartilage placed against the hole, reached either through a cut behind or above the ear or through the ear canal. Some surgeons use an endoscope instead of a microscope.

You can usually go home the same day, with a dressing or pack in the ear.

ENT UK lists temporary change in taste (permanent disturbance is uncommon), dizziness lasting hours and rarely months, hearing loss (rare but possible), tinnitus and temporary facial weakness, with permanent weakness very rare. Dorset adds that facial nerve damage and rare permanent inner-ear hearing loss are possible. Failure of the graft to take is also a recognised outcome: Dorset gives about 80% complete healing, lower for large holes and for children under 13.

Standard general anaesthetic risks apply and will be explained at pre-assessment.

Expect soreness, crackling sounds and numbness behind the ear, which fade. ENT UK suggests one to two weeks off work and stitches out at one to two weeks, with dressings removed at two to three weeks. Dorset gives packing removed at two weeks, a hearing test at six weeks and a final check at about eight weeks.

Avoid blowing your nose, and keep the ear dry with cotton wool smeared with Vaseline when washing.

• Increasing pain or swelling around the ear.

• New discharge or a smell from the ear.

• Facial weakness or drooping: seek urgent medical review.

• Severe dizziness or sudden loss of hearing.

• How big is the hole, and what is the chance it will close?

• Will you use skin or cartilage and why?

• What will my hearing be like afterwards?

• When can I fly, swim and return to work?

Eardrum surgery is a specialist ear operation. NHS lists may be shorter for people with recurrent infections and longer for dry perforations that cause few problems. Privately you can usually choose an ear surgeon and date. In either setting, ask how many of these operations the surgeon does and what follow-up hearing test is booked.