How do you repair a perforated ear drum?

The operation involves placing a graft under the perforation. The graft material is a thin sheet of membrane, usually taken from beneath the skin behind the ear - called temporalis fascia. This provides a scaffold for the cells of the migrate over the graft. . 

Our preference is to perform the surgery through an incision behind the ear. Whilst there is a scar, this is hidden behind the ear that usually heals very well and is not noticeable.

A flap of ear canal skin is elevated to include the tympanic membrane to allow access to the middle ear

The graft is then placed under the tympanic membrane, covering the perforation. This acts as a scaffold allowing the edges of the perforation to migrate over the graft

Once the graft is in place, the ear is packed with a resorbable dressing

If some of the three tiny bones in the middle ear (ossicles) have been damaged , reconstruction of these (ossiculoplasty) can be performed at the same time. 

The operation usually takes about an hour and a half, and may be performed as a day case if carried out early in the day.