Myringoplasty and Tympanoplasty in London
Specialist assessment and eardrum reconstruction with Mr Max Whittaker, Consultant ENT Surgeon specialising in otology and ear surgery.
Myringoplasty and tympanoplasty are operations used to reconstruct the tympanic membrane. Tympanoplasty may also involve treatment of additional middle-ear structures where clinically required.
Repair of the tympanic membrane with additional middle-ear reconstruction where required.
Why might eardrum reconstruction be considered?
Many perforated eardrums heal without surgery. Reconstruction may be considered when a perforation remains open or continues to cause problems.
A persistent perforation can affect sound transmission through the middle ear and may contribute to hearing loss.
Some patients also experience recurrent discharge or infections, particularly when water enters the middle ear through the perforation.
Surgery is not automatically required. The decision depends on the individual ear, hearing, infection history, symptoms and whether additional middle-ear disease is present.
Myringoplasty and tympanoplasty
Both operations involve the tympanic membrane, but the terminology generally reflects how much reconstruction is required.
Myringoplasty
Myringoplasty generally refers to surgical repair of a persistent hole in the eardrum.
- Repairs the tympanic membrane
- Uses graft material to support reconstruction
- Can be performed through different surgical approaches
- Requires postoperative healing and follow-up
Tympanoplasty
Tympanoplasty may include reconstruction of the eardrum together with treatment of additional middle-ear disease or structures.
- Reconstructs the tympanic membrane
- Allows treatment of associated middle-ear disease
- May include ossicular assessment or reconstruction
- Procedure is tailored to the clinical findings
Assessment determines whether surgery is appropriate
A perforation should be assessed in the context of the whole ear rather than treated simply because a hole is visible.
History
Hearing change, discharge, infection, previous surgery, trauma and other symptoms are reviewed.
Eardrum examination
The size, position and condition of the perforation and surrounding tympanic membrane are assessed.
Hearing assessment
Audiology may help determine whether hearing loss is conductive, sensorineural or mixed.
Middle-ear assessment
Associated disease or damage to the hearing bones may influence the type of operation recommended.
How can myringoplasty or tympanoplasty be performed?
The surgical approach depends on the anatomy of the ear, the location of the perforation and whether additional middle-ear treatment is required.
Ear-canal approach
Selected cases may be approached using an endoscope through the ear canal, providing wide-angle and angled views.
Endoscopic Ear Surgery →Operating microscope
Microscopic surgery remains appropriate for many myringoplasty and tympanoplasty procedures and allows two-handed operating.
Both techniques
Some ears benefit from combining microscopic and endoscopic views during different stages of the operation.
What is eardrum reconstruction intended to achieve?
Reconstruct the eardrum
The operation aims to close or reconstruct the persistent opening in the tympanic membrane.
Create a more protected middle ear
Closing the perforation can help reduce direct exposure of the middle ear to water and environmental contamination.
Address associated disease
Tympanoplasty may allow additional middle-ear disease or structural problems to be treated.
Support hearing where possible
Hearing may improve in some patients, but the outcome depends on the condition of the eardrum, ossicles, middle ear and inner ear.
Can myringoplasty improve hearing?
Eardrum reconstruction may improve sound transmission for some patients, but hearing outcome cannot be guaranteed.
Hearing depends on more than the tympanic membrane alone.
The middle-ear hearing bones, mobility of the ossicular chain, condition of the middle ear and inner-ear function can all affect hearing.
If the hearing bones are damaged or disrupted, ossiculoplasty may be considered as part of a wider reconstructive procedure.
Learn about Ossiculoplasty →Recovery after myringoplasty or tympanoplasty
Recovery varies according to the procedure, approach, amount of reconstruction and individual healing.
Read Recovery GuidesEar packing
Packing or dressing may be placed in the ear after surgery depending on the procedure.
Hearing may initially feel different
Packing, swelling and the healing process can temporarily affect hearing after surgery.
Keep the ear dry
Water precautions are commonly required while the reconstructed eardrum heals.
Attend follow-up
Follow-up allows the surgeon to review the graft, remove packing where required and assess healing.
Return to activities gradually
Your surgeon will advise when work, exercise, swimming and other activities can safely resume.
Flying requires individual advice
Do not rely on a universal number of weeks. Your surgical team should confirm when it is safe for you to fly after surgery.
Specialist expertise in reconstructive ear surgery
Mr Max Whittaker has a specialist interest in otology, chronic ear disease, hearing loss and endoscopic ear surgery.
His advanced training includes Otology and Skull Base Surgery at Guy’s and St Thomas’, together with international observerships at the House Institute in California and Toronto General Hospital.
He holds an MSc with Distinction in Audiovestibular Medicine from University College London and is Clinical Lead in Otolaryngology at Homerton Healthcare NHS Foundation Trust.
From perforation assessment to reconstruction
Book your consultation
Submit a secure appointment request through the booking page and indicate your preferred clinic.
Request consultation →Examine the eardrum and middle ear
The perforation and surrounding ear structures are assessed together with your symptoms and clinical history.
Review hearing
Hearing tests may help determine whether the perforation or another part of the ear is contributing to hearing loss.
Decide whether surgery is appropriate
The risks, potential benefits, surgical approach and alternatives can be discussed according to the individual findings.
Common questions about eardrum reconstruction
General information cannot determine the most appropriate treatment for an individual ear.
Myringoplasty is an operation to reconstruct a persistent perforation of the tympanic membrane using graft material.
Myringoplasty generally refers to repair of the eardrum itself. Tympanoplasty can include wider reconstruction or treatment within the middle ear.
Normal hearing cannot be guaranteed. Hearing outcome depends on the tympanic membrane, hearing bones, middle ear and inner-ear function.
Selected cases may be suitable for an endoscopic approach. Other ears may be better treated microscopically or with a combined technique.
There is no single interval that should be applied to every patient. Your surgeon should confirm when your ear has healed sufficiently for you to fly.
Use the secure Book Consultation page to submit an appointment request. The clinic team will contact you to confirm availability and appointment details.
Discuss whether myringoplasty is appropriate for you
Request a private consultation with Mr Max Whittaker for specialist assessment of your perforated eardrum, hearing and treatment options.