WHAT IS IT?

A hole in the eardrum allows the bacteria on the surface of the skin to enter the delicate middle ear. This can cause infection. During a head cold the pink skin lining the nose and middle ear space produces mucus and this can leak out though a hole in the eardrum causing discharge. If you have an infection you should avoid getting water in the ear.

If the hole is large then you may experience some hearing loss.

WHAT CAN BE DONE ABOUT IT?

If the hole in the eardrum has only just occurred, no treatment may be required. You should discuss with your surgeon whether to wait and see, or have surgery.

An operation to repair the perforation is called a myringoplasty. The benefits of closing a perforation include prevention of water entering the middle ear, which could cause ear infection. You should get fewer ear infections. It may result in improved hearing, but repairing the eardrum alone seldom leads to great improvement in hearing.

WHAT DOES THE OPERATION INVOLVE?

The operation is almost always done under general anaesthetic.

A cut is made behind the ear or above the ear opening. Occasionally, your surgeon may need to widen the ear canal with a drill to get to the perforation. The material used to patch the eardrum is taken from under the skin. This eardrum 'graft' is placed against the eardrum. Dressings are placed in the ear canal. The operation can successfully close a small hole nine times out of ten.

WHAT CAN GO WRONG?

There are some risks that you must be aware of before giving consent to this treatment. These potential complications are rare. You should consult your surgeon about the likelihood of problems in your case.

1. Taste disturbance: The taste nerve runs close to the eardrum and may occasionally be damaged. This can cause an abnormal taste on one side of the tongue. This is usually temporary but occasionally it can be permanent.

2. Dizziness: Dizziness is common for a few hours following surgery. On rare occasions, dizziness is prolonged.

3. Hearing loss: In a very small number of patients, severe deafness can happen if the inner ear is damaged.

4. Tinnitus: Sometimes the patient may notice noise in the ear, in particular if the hearing loss worsens.

5. Facial Paralysis: The nerve for the muscle of the face runs through the ear. Therefore, there is a very rare chance of a facial paralysis. The facial paralysis affects the movement of the facial muscles for closing of the eye, making a smile and raising the forehead. The paralysis could be partial or complete. It may occur immediately after surgery or have a delayed onset. Recovery can be complete or partial.

6. Reaction to ear dressings: Occasionally the ear may develop an allergic reaction to the dressings in the ear canal. If this happens, the outer ear may become swollen and red. You should consult your surgeon so that he can remove the dressing from your ear. The allergic reaction should settle down after a few days.

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