Mr Ananth Vijendren, Consultant ENT Surgeon, has a keen interest in the variety of microscopic and endoscopic techniques available to treat a perforated eardrum. Here he explains the symptoms of a perforated eardrum and the surgical treatment available.
Why does an eardrum perforate?
If an eardrum is perforated, it means a hole has formed. There are many reasons for this. Commonly, it occurs after an ear infection, trauma (either externally or through cotton bud usage) or sometimes even from medical procedures performed, such as grommets or earwax removal. Not infrequently, there may not be a cause and it is thought that the perforation has arisen as the body’s natural way to equalise pressure with the outside world.
What problems can a perforated eardrum cause?
A hole in the eardrum allows water to move freely from the external ear canal into the middle ear. This forms a reservoir for infections and patients may experience a discharging ear, which can be very uncomfortable and foul smelling. As a result, it is strongly advised these patients keep their ears as dry as possible. This can be very difficult for keen swimmers and people who work with water activities.
Additionally, an eardrum perforation can also affect one’s hearing, which has implications on their activities and daily living.
What are the symptoms of a perforated eardrum?
Symptoms of a perforated eardrum include:
- Earache or pain in the ear
- Hearing loss. Either struggling to hear or your hearing may be slightly muffled
- Tinnitus (ringing in the ear)
- Vertigo (spinning sensation sometimes resulting in sickness)
- Discharge from the ear
- A high temperature
- Itchy inner ear
How do you treat a perforated eardrum?
It is important to note that many perforations can heal spontaneously and hence it is worth waiting a while to see if this happens. If patients continue to be troubled by discharge, hearing loss or limitations on their daily life, a surgical repair can be undertaken.
What does surgery involve?
Surgery is usually done as a day case operation under general anaesthetic and can be performed through the ear canal itself or with an incision either in front or behind the ear. A variety of techniques are available, using either high-definition endoscopes or operating microscopes under high magnification. Your ENT surgeon will spend time going through different options based on preferences and success rates. A graft is taken from soft tissues or cartilage within the ear and used to repair the hole. At the end of surgery, patients may wake up with a head bandage around their head and packing material within their ear.
Surgery to reconstruct the ear drum is known as myringoplasty. A tympanoplasty would be recommended if it is necessary to reconstruct the ear drum and middle ear hearing apparatus.
What is the recovery time?
Patients will be able to go home after 2-3 hours of the procedure and can remove the head bandage themselves the next day. It is advisable to have 1-2 weeks off work.
Your ENT surgeon would usually arrange to see you in 2 weeks to remove any packing material from your ear.
What is the success rate?
Studies show that the success rate of closing up the perforation can be up to 90% depending on technique and graft material used.
How can I find out more?
Mr Ananth Vijendren is a Consultant ENT Surgeon with a sub-specialty interest in adult and paediatric ear-related diseases, balance and hearing reconstruction. Mr Vijendren has regular clinics at One Hatfield Hospital.