myringoplastie

Myringoplasty is a surgical procedure aimed at repairing a perforated tympanic membrane (eardrum). It is a focused repair of the membrane itself, and is often described as tympanoplasty when additional reconstruction of middle ear structures is performed. The goal is to restore the barrier between the ear canal and middle ear, improve hearing, and reduce recurrent ear infections.

Indications include persistent perforation after trauma or infection, chronic otorrhea, and conductive hearing loss attributable to the perforation. It is typically considered when the perforation fails to heal spontaneously and symptoms persist.

Techniques involve approaches through the ear canal (transcanal) or behind the ear (postauricular) under general anesthesia or local; graft materials are placed either under or over the remaining tympanic membrane. Common grafts include temporalis fascia and tragal perichondrium; cartilage grafts may be used in certain cases. The surgeon secures the graft with sutures and sometimes adhesives; the procedure lasts 60–90 minutes.

Outcomes: Success rates vary with extent of middle-ear disease, but durable tympanic membrane closure occurs in roughly 70–90% of cases. Hearing improvement depends on middle-ear conditions; some improvement in air-conduction thresholds is common. Risks include graft failure, infection, persistent perforation, cholesteatoma progression if present, bleeding, tinnitus, and rarely sensorineural hearing loss or vertigo.

Recovery: Patients are advised to avoid water in the ear, nose blowing, and strenuous activity for several weeks; follow-up checks assess graft take and healing. Full recovery may take several weeks.