Tympanoplasty — Procedure Guide, Recovery & Risks | MyMedicPlus

Tympanoplasty repairs a perforated tympanic membrane (eardrum) using a biological graft — typically temporalis fascia or tragal perichondrium/cartilage — to restore normal hearing conduction and provide a barrier against recurrent middle ear infections.

Indicated for persistent eardrum perforation caused by chronic suppurative otitis media (CSOM), trauma, or failed grommet extrusion, particularly when the perforation causes conductive hearing loss greater than 15–20 dB or recurrent ear discharge.

Temporalis fascia or tragal perichondrium is harvested and dried. Via transcanal or post-auricular approach, the eardrum remnant is elevated and the graft placed in an underlay (medial) or overlay (lateral) position, secured with absorbable gel foam packing.

Water must be kept out of the ear for 6–8 weeks. Hearing improves gradually over 4–6 weeks as packing dissolves. Avoid forceful nose-blowing and strenuous activity for 4 weeks to prevent displacement of the healing graft.

Risks include graft failure and re-perforation (10–15%), persistent conductive hearing loss, sensorineural hearing loss (rare, <1%), tinnitus, taste disturbance from chorda tympani nerve stretch, dizziness, and delayed wound healing behind the ear.

Graft take rates exceed 85–90% with temporalis fascia in primary surgery. Hearing improvement of 10 dB or more is achieved in 70–80% of cases. Success rates are higher in non-smoking patients with a dry, infection-free ear at the time of surgery.