Tympanoplasty (tympanic membrane repair)

Tympanoplasty is a surgical treatment used to address various hearing problems caused by a perforated eardrum. This condition may result from several factors, most commonly chronic otitis media (a persistent middle ear infection), the insertion of objects into the ear canal – such as cotton buds – or trauma that has not healed properly.

Tympanic membrane repair surgery can help improve hearing and prevent recurrent ear infections. 

Tympanoplasty involves cleaning the affected cavity, repairing the eardrum, and, when necessary, reconstructing the tiny bones adjacent to the eardrum (the malleus, incus, and stapes).

The eardrums are membranes that form part of the wall of the middle ear, located between the outer and middle ear. This small, thin, drum-like structure plays a vital role in hearing. 

The tympanic membrane captures sound in the form of vibrations and transmits them as nerve impulses to the nervous system via the organs of the inner ear.

In addition, this structure acts as a protective barrier against very loud or low-frequency sounds. Therefore, when an infection, perforation or deterioration of the eardrum occurs, these sounds may reach the inner ear and seriously affect hearing ability.

It is important to note that eardrum perforations can be caused by various factors, including chronic or acute otitis media, fractures or trauma to the temporal bone, the forced insertion of foreign objects, iatrogenesis (damage caused by medication or a medical-surgical procedure performed by a healthcare professional), or exposure to an explosive wave. These situations often damage not only the eardrum but also the adjacent ossicles located within the ear.

What limitations can affect the eardrums?

As previously mentioned, the tympanic membranes can have their function impaired due to infection or trauma caused by external factors such as acute or chronic otitis media, temporal bone fractures, the forced insertion of objects, or as a consequence of previous surgeries.

The eardrum is an extremely delicate and vulnerable structure, so it is important to take great care. This includes avoiding acoustic trauma (very loud noises) and being cautious of barotrauma (sudden pressure changes between the inside and outside of the ear). These situations can lead to ear infections, damage the eardrum’s health, and increase the risk of pus or fluid build-up, which may press against the membrane until it ruptures. They may also result in hearing loss or even permanent deafness.

To relieve the symptoms caused by a perforated or ruptured eardrum, several treatments are available. These aim to reduce pain and prevent further infections. Initially, non-surgical treatment may be recommended, involving the use of antibiotics and keeping the ear clean and dry until it heals on its own (typically within around 2 months).

However, if drug treatment proves ineffective, specialists recommend surgical intervention, known as tympanoplasty, which restores the tympanic membrane and, when necessary, includes reconstruction of the adjacent ossicles.

There are several reasons why tympanoplasty surgery is performed, although all are focused on relieving any discomfort you may be experiencing and eliminating both hearing limitations and any issues that could affect your daily life.

Among the most common situations where a person may be a candidate for tympanoplasty, we highlight the following:

• Chronic otitis media: This condition involves inflammation of the middle ear that may become infected, discharge fluid, and cause internal drainage. It is usually caused by a perforation in the tympanic membrane and, if left untreated, can lead to significant discomfort (fever, pressure in the ear, serious hearing loss, etc.). When medication and conservative care are ineffective, surgical treatment—tympanoplasty—is often the most appropriate solution.
  
  
• Rupture of the eardrum and ossicles due to trauma: Sudden changes in pressure or blows to the head can fracture the skull. This increases internal ear pressure, potentially tearing or rupturing the eardrum and the chain of adjacent ossicles.
  
  
• Build-up of tissue around or behind the eardrum: When an infection occurs in the middle or inner ear, pus and fluids may accumulate behind or around the eardrum. This pressure can cause the membrane to rupture. This issue is especially common in children, and surgery often becomes the most effective solution.
  
  
• Hearing loss or deafness: These may result from eardrum perforation. Although the tympanic membrane may regenerate with medication, the ossicular structure could remain damaged, making surgery necessary.

Before deciding whether to undergo surgery, you should book a free consultation with our specialist in ENT Surgery through the Operarme website. 

This in-person consultation allows the surgeon to assess your case and determine whether the procedure is appropriate for you. We recommend bringing along any medical reports or test results related to your condition, as they will assist the doctor in their evaluation.

After you request the consultation via our website, one of our personal patient care advisers will contact you to confirm the date and answer any questions you may have. You can also request information at any time by calling at +34 91 141 33 56, or by filling out the contact form.

Do you need surgery to repair your eardrum?

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On the day of your appointment, the doctor will review any medical reports you bring and carry out a medical interview to better understand the symptoms caused by the inflammation and infection in the affected ear. 

They will also examine the ear canals to become familiar with your specific case, allowing for a more accurate diagnosis and to determine the most appropriate treatment for you or your child.

During this consultation, the specialist will explain what the tympanoplasty surgery involves and will answer any questions you may have. Don’t hesitate to ask about any aspect of the procedure or your condition—being well informed will help you make the best decision.

If, together with the specialist, you decide that tympanic membrane repair is the most suitable option for your case or your child’s, the surgery date can be scheduled during the same consultation. In any case, our patient service team will follow up with you and manage the entire process.

As with any surgical procedure, a preoperative assessment must be carried out, which includes the following tests:

• Blood test: to rule out signs of infection or other factors that could complicate the operation.
• Chest X-ray: this is used to check for respiratory problems and is usually only performed if the specialist deems it necessary.
• Electrocardiogram (ECG): allows the specialist to assess your heart’s health.
• Computed tomography (CT scan): performed only when specifically indicated by the specialist. This test provides a detailed view of the internal structure of the skull and can help detect infections or foreign bodies in the ear cavity. As this test is only required in certain cases, it is not included in the standard surgery fee and will need to be paid separately by the patient. Please contact our patient service team for more information.

In the days leading up to the operation, you will be advised to stop taking anti-inflammatory medication, unless otherwise instructed by your doctor. 

You should also follow all preoperative instructions provided by the specialist, including dietary recommendations, quitting smoking, ear care and hygiene, etc.

Anaesthesia for tympanoplasty (tympanic membrane repair)

The procedure is typically performed under local anaesthesia with sedation. However, in some cases, general anaesthesia may be used, depending on the surgeon’s assessment.

Throughout the entire tympanoplasty procedure, the anaesthetist will remain by your side, monitoring your vital signs and adjusting the anaesthetic levels. You will also receive medication during the operation to ensure you feel no pain.

Tympanoplasty is a relatively straightforward and highly precise surgical procedure. It is often performed as an outpatient surgery, meaning you can usually return home the same day without the need for hospital admission, depending on the surgeon’s recommendation.

Below, we explain what the day of the procedure would typically look like:

When you arrive at the hospital, you will be asked to present the required documentation at the admissions desk. You will then be taken to the operating theatre area, where you’ll be asked to change into surgical clothing.

Once ready, you will be taken into the operating room, where you will meet the surgeon you previously consulted with, the anaesthetist, and a member of the nursing team. 

After being positioned on the operating table as instructed by the surgeon, the surgery will begin:

1. First, the anaesthetist will administer the appropriate anaesthesia—either local with sedation or general. You will feel its effect quickly and will not experience any pain or discomfort during the procedure.
2. Once the anaesthesia takes effect, the surgeon will make an incision either behind the affected ear or within the ear canal.
3. The surgeon will then access the targeted area and clean out any infection, damage, or disease within the ear. They will then trim the edges of the torn eardrum or, if necessary, remove the entire membrane. In such cases, a tissue graft or prosthetic implant may be required. This is not included in the base price of the surgery and must be paid for separately by the patient. Please speak with our Patient Service Team for more information.
4. The next step involves using a graft to close or replace the torn eardrum. This graft may be taken from another part of your body or made from synthetic material.
5. Once the graft is in place, a few small, absorbable stitches will be used to secure it.
6. To finish, antibiotic foam will be applied to the ear canal to help prevent infection. Finally, the surgical instruments will be removed and the initial incision will be closed with sutures.

Once the tympanoplasty surgery has been completed, you will be taken to the postoperative recovery room, where you will recover from the effects of the anaesthesia under the close supervision of the nursing team. Depending on the complexity of the procedure, you may be discharged the same day or asked to stay in the hospital for one additional night until you are ready to continue your recovery at home.

Tympanoplasty surgery typically lasts between 1 and 2 hours, depending largely on the complexity of each case—especially if additional procedures such as a mastoidectomy (surgery to remove the air-filled spaces in the skull behind the ear, known as mastoid air cells) or ossicular chain reconstruction are required.

After leaving the operating theatre, you will be taken to the postoperative recovery room where you will recover from the effects of the anaesthesia. 

During your hospital stay, there is no need to worry—this stage is usually not painful. The most common discomforts include mild ear discomfort, occasional dizziness, facial numbness, or slight bleeding that may stain the dressing.

To ease these postoperative symptoms, you will remain under the care of the medical team, who will provide you with fluids and soft foods, as well as apply local cold compresses to reduce swelling and pain. They will also monitor the area to ensure there is no significant bleeding or bruising before you are discharged.

Once you return home, your doctor will prescribe medication to relieve any remaining symptoms such as inflammation, minor bleeding, or discomfort. These will typically include anti-inflammatory drugs and antibiotics. As for the stitches used to close the incision, these are usually removed after 5 to 7 days.

The length of the recovery process varies from patient to patient. However, improvement is generally noticeable after the first week following surgery, with full recovery expected from around 15 days onwards.

The main advantage of tympanoplasty is that it repairs the perforation or rupture of the tympanic membrane and resolves related issues such as infection, inflammation of the ear canal, and hearing loss. This restores the ear’s proper function and significantly improves the patient’s quality of life.

It is also considered a relatively straightforward technique that does not reduce the space in the middle ear and has a high success rate.

As for the risks, like any surgical procedure, complications may arise—though they are rare. In the case of tympanoplasty, potential risks include persistent dizziness, bleeding, implant rejection, or scarring issues. These are usually linked to each patient’s specific clinical condition and can be managed with tailored advice from the specialist.

If you would like more information about the price, what is included, or any other aspect of the procedure, please contact our Patient Service Team via the contact form.

Do you need surgery to repair your eardrum?

Request a free and immediate appointment with our specialists in Otorhinolaryngology

Request an appointment