What Is a Tympanoplasty?

A tympanoplasty is a surgical procedure to repair a hole in the eardrum (tympanic membrane) and, if necessary, improve the function of the small hearing bones in the middle ear. The eardrum plays an essential role in hearing by transmitting sound vibrations.

Why Is Surgery Needed?

Tympanoplasty may be recommended for patients with:

• A persistent hole in the eardrum
• Hearing loss
• Recurrent ear infections
• Ear drainage
• History of trauma or prior ear surgery

If the eardrum does not heal on its own, surgery can restore function and prevent ongoing problems.

Goals of Surgery

• Close the eardrum perforation
• Improve hearing
• Prevent infections
• Restore normal ear function

How the Procedure Is Performed

• Typically performed under general anesthesia
• The eardrum is repaired using a graft (often from the patient’s own tissue)
• Hearing bones may be repaired or adjusted if needed
• Approach may be:
  • Through the ear canal, or
  • Through a small incision behind the ear
• Packing is placed in the ear to support healing
• Procedure duration: approximately 1–2 hours

What to Expect After Surgery

• Most patients go home the same day
• Mild discomfort or ear fullness is common
• Hearing is often temporarily muffled
• Brief dizziness may occur

Recovery

• Healing takes several weeks
• Keep the ear completely dry
• Avoid nose blowing, heavy lifting, and straining
• Follow-up visits are essential
• Hearing improves gradually over time

Benefits

• Closure of the eardrum hole
• Improved hearing
• Reduced infections
• Return to normal water activities after healing

Risks

Although generally safe, possible risks include:

• Failure of graft healing
• Persistent hearing loss
• Infection
• Dizziness
• Rare taste disturbance
• Very rare facial nerve weakness

Post-Operative Instructions

Diet

• Start with liquids or a light diet due to possible nausea or dizziness
• Resume a normal diet the following day
• Mild jaw discomfort with chewing may occur

Wound Care

• The ear will feel full or clogged; crackling sounds are normal
• Mild swelling around the ear, temple, or eye may occur
• Keep all dressings dry
• Dressings are typically removed after 1–2 days

Ear Care:

• Use a cotton ball in the ear; change when soaked
• Apply a small amount of antibiotic ointment to help it stay in place
• Do not allow water into the ear
• Use a Vaseline-coated cotton ball during showering
• A shower cap is recommended

Cleaning:

• Outer ear crusting can be cleaned with peroxide and Q-tips
• Bloody or dark drainage is normal for the first week
• Do not remove internal packing (may appear as dark material or Gelfoam)

Incision Care:

• Incision behind the ear can be washed after 48 hours

Pressure Precautions

• Do not blow your nose for at least 2 weeks
• Sneeze with your mouth open
• Sleep on the non-operated side

Medications

• Antibiotics may be prescribed if needed
• Use pain medication as needed (may cause drowsiness, nausea, constipation)
• Avoid driving or operating machinery while on pain medication
• Begin prescribed ear drops 1 week after surgery and continue for 2 weeks

Activity Restrictions

• Walking is allowed the day of surgery
• Return to work: typically 5–7 days
• No vigorous exercise for 2 weeks
• No heavy lifting for 4 weeks
• No flying for 4 weeks
• No swimming for 4 weeks
• No scuba diving for 3 months

Follow-Up

• Dressing (if present) may be removed at home after 24 hours
• Follow-up visit scheduled at 7–10 days
• Ear may be partially cleaned using a microscope and suction
• Contact your surgery coordinator if unsure about your appointment

When to Contact the Office

Report the following:

• Severe headache
• Persistent dizziness or vertigo
• Ongoing vomiting
• Fever above 102°F not responding to Tylenol or Motrin
• Facial weakness (difficulty closing the eye or uneven smile)

Additional Information

• Medication refills are not available after hours or on weekends
• Call during office hours (Monday–Friday, 8:30 am – 4:30 pm) for refills

Emergency Room Guidelines

• Patients 16 and older: Centennial Medical Center Frisco
• Patients under 16: Children’s Medical Center Plano