How do you close a hole in the ear drum ( tympanoplasty)?

The operation involves placing a tissue graft under the perforation which  provides a scaffold for the edges of the perforation to heal over. The graft material is a thin sheet, usually taken from beneath the skin behind the ear - an area called the temporalis fascia. Sometimes cartilage is also used.

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

The skin of the back of the ear canal is elevated with 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 the three tiny bones of your middle ear (ossicles) have been damaged by middle ear disease or trauma, reconstruction of these (ossiculoplasty) can be performed at the same time. 

The operation usually takes about 90 minutes, and may be performed as a day case if carried out early in the day.