Perforated Tympanic Membrane (Tympanoplasty)
The tympanic membrane (eardrum) is a very important structure that is involved with hearing. It is a thin membrane, about half the size of a dime, and it is located at the end of the ear canal. When sound waves enter the ear canal, the tympanic membrane vibrates. This transmits the sound energy through several tiny bones to the inner ear. This signal then travels from the inner ear to the brain, where it is perceived as sound.
Left eardrum with perforation
If there is a hole (perforation) in the tympanic membrane, the hearing mechanism is disrupted. While hearing will not be completely gone, there can be a substantial hearing loss associated with a tympanic membrane perforation. The degree of hearing loss depends on the size and location of the perforation on the eardrum.
The main causes of a tympanic membrane perforation are trauma and infection. Examples of ear trauma include being hit directly on the ear, jumping into a pool and having the water hit the ear, or experiencing rapid changes in air pressure such as with scuba diving or sky diving. Alternatively, a bad ear infection can cause a perforation which may not spontaneously heal.
Most tympanic membrane perforations will heal spontaneously. However, if a perforation has persisted for several months, there is a good chance that it will remain. Many patients with tympanic membrane perforation are candidates to have the perforation surgically closed. This is an operation called a tympanoplasty. Patients who undergo tympanoplasty will usually be discharged home the same day. Tympanoplasty may be performed alone, or in conjunction with other procedures such as ossiculoplasty or mastoidectomy. Your physician will discuss what procedure is appropriate for you.