Myringoplasty Tympanoplasty

Type 1 tympanoplasty, also called myringoplasty, is the surgical procedure to repair (close) a tympanic membrane perforation (a hole in the eardrum). There are other types of tympanoplasty which we will not discuss here.

Tympanoplasty is performed by a specialized ENT surgeon and in children is always done under general anesthesia.
The incision is made either behind the ear or in front and above the opening of the external auditory canal. To close the eardrum perforation, a graft is used, which usually consists of temporal fascia, the membrane covering the temporal muscle. This is simply harvested from the same incision just beneath the skin. Then, using a specific surgical technique, the graft is placed to cover the perforation and is stabilized by placing special gauze in the external auditory canal. The skin incision is closed with special absorbable sutures and dressed with a bandage around the head. This bandage usually remains around the child’s head overnight to prevent the possible complication of a hematoma (collection of clotted blood) under the wound.

The success rates of tympanoplasty are very high, around 90% in experienced surgical hands. This naturally depends on other factors such as the size of the perforation, presence or absence of infection in the ear during surgery, and the overall clinical condition of the patient.
The most common complication is infection, mainly at the skin incision, which is usually effectively treated with antibiotics. There is also a risk of bleeding or hematoma under the incision, but this is minimized by applying the head bandage as mentioned.
The only other possible complication in simple tympanoplasty (myringoplasty) is usually a temporary alteration in taste on the front part of the tongue in children, due to injury to a nerve (the chorda tympani) that passes just behind the eardrum. However, the chance of affecting this nerve is very small.