Tympanoplasty (eardrum reconstruction)

Tympanoplasty is surgery to repair a ruptured eardrum (hole or tear in your eardrum). Your eardrum is the tissue that separates your outer ear from your middle ear. A ruptured eardrum can cause hearing difficulty and balance issues.

During eardrum reconstruction, your surgeon uses a microscope or endoscope (thin, flexible tube with a light and camera) to enter your ear and find the hole. Then, they close it with a graft, a patch of your own tissue or manufactured tissue.

Penn Medicine’s otology and neurotology physicians are experts in eardrum reconstruction. We’re nationally recognized for treating ear problems, and our team is among the most experienced in the region.

You may need eardrum reconstruction if your ruptured eardrum doesn’t heal on its own or with medication (such as ear drops or antibiotics) within two to three months. You know your eardrum isn’t healing if you’re still experiencing symptoms, such as hearing loss or bloody, mucus-like drainage from your ear.

A ruptured eardrum may be caused by:

• Acoustic trauma (from an extremely loud sound
• Barotrauma from severe pressure changes)
• Foreign object (such as a cotton swab)
• Head or ear trauma
• Middle ear infection

Before surgery, your doctor may perform a hearing test or tympanometry, which checks your eardrum’s function. They may also order a computerized tomography (CT) scan to get a better image of your eardrum.

Tympanoplasty is usually an outpatient procedure, so you should be able to go home the same day. Sometimes, your doctor may want you to spend the night to watch for complications. A simple eardrum repair may be performed with local anesthesia at your doctor’s office. However, most eardrum repairs are performed in an operating room.

Here’s what to expect during eardrum reconstruction:

1. You receive general anesthesia so that you don’t feel any pain.
2. Your surgeon enters your ear through your ear canal or an incision behind or in front of your ear.
3. They take a small piece of tissue from the muscle near your temple (area on the side of your head between your eye and ear) to patch the hole. This tissue is called a graft.
4. Using a microscope or endoscope, your surgeon locates the hole and closes it with the graft.
5. They secure the graft with foam, which eventually dissolves when your eardrum grows new tissue and heals.
6. If your surgeon had to make an incision, they close it.

The length of surgery depends on what kind of repair is needed. A small hole may take only a few minutes to repair. A full reconstruction may take several hours. Some people also need surgery to repair the tiny bones in the middle ear (ossicles). If you need ossiculoplasty, your doctor will perform it at the same time as tympanoplasty.

Eardrum reconstruction is successful approximately 93 percent of the time.

You may have pain for a few days after tympanoplasty. Usually, it can be managed with over-the-counter pain medication. If you have a little blood coming out of your ear, place a cotton ball in it. If you experience a lot of bleeding, call your doctor.

The recovery time for eardrum reconstruction ranges from a few days to a few weeks. It’s important to take it easy during this time. Avoid sports, heavy lifting, and vigorous exercise. It may take a few months or more to recover fully with your hearing back to normal.

Avoid blowing your nose while you’re waiting for your eardrum to heal. When you sneeze, try to keep your mouth open. You should also avoid getting your ear wet. When you shower, place a cotton ball coated with petroleum jelly in your ear, and don’t swim for four to six weeks after your surgery.

Eardrum reconstruction isn’t a high-risk procedure, and complications are rare. When they do occur, they usually stem from problems with the graft—it doesn’t fix the problem, your hearing worsens, or surgery causes another hole in your eardrum.

Our renowned otologists and neurotologists offer the latest surgeries for eardrum reconstruction, including endoscopic procedures. We choose the least invasive approach to minimize pain and speed your recovery. People throughout southeastern Pennsylvania turn to Penn Medicine for our surgical excellence and comprehensive care.