Myringoplasty

The eardrum, also known as the tympanic membrane, is a paper-like, thin structure present between the middle and outer parts of the ears. It helps in hearing by the vibrating response to the sound waves.
The eardrum may get ruptured due to head trauma, ear infections, sudden loud noises, and sticking objects in the ear.

Symptoms

A myringoplasty is generally recommended in the following cases:

1. A ruptured eardrum that has failed to heal in the last three or four months
2. Presence of chronic or recurrent ear infections
3. Loss of hearing due to a ruptured eardrum
4. Sustains trauma that causes a torn eardrum

Diagnosis

1. Physical examination: The doctor will evaluate the patient physically and ask about any recent ear injuries or trauma.
2. Urine tests: These tests help to check the urinary tract for the presence of any infections or diabetes.
3. Blood tests: These tests help to determine the blood type of the patient, whether or not they have any infections, how quickly the blood can clot, and the presence of conditions like anemia (when there are insufficient blood cells to carry oxygen throughout the body).
4. Chest x-ray: It helps the doctor to evaluate the condition of the heart and lungs.
5. Magnetic resonance imaging (MRI) scan: This is a type of imaging test that helps the doctor to obtain clear images of the internal organs of the body.

Treatment

Myringoplasty is generally performed under general anesthesia, that is, the patient is put to sleep during the procedure. In some cases, myringoplasty may be performed under local anesthesia, that is, the treatment area will be numbed before the procedure.
The procedure may be performed using any one of the following techniques:

1. Underlay technique: This technique is useful for small eardrum ruptures. It is done in the following way:
An incision is first made behind the ear to remove a strip of the epithelial layer.
A graft is then placed beneath the skin to support the eardrum.
The ear is then filled with antibiotic cream.
A bandage is applied to protect the ear canal from external infections.

2. Overlay technique: This procedure is useful for severe cases of eardrum perforations that cannot be treated using the underlay technique. It is performed in the following way:
An incision is made to raise the ear’s medial meatal skin.
A graft is then placed outside the eardrum.
An antibiotic is then filled in the ear and then packed with a bandage.
The procedure takes about 30 to 90 minutes to complete.

The different types of grafts used for myringoplasty include:

1. Synthetic materials: These materials may include gel foam and surgical paper.
2. Temporalis fascia: This is a strong layer of connective tissue that covers the temporalis muscle (a muscle used for chewing and present on each side of the head). A small part of the temporalis fascia is removed and harvested to patch the eardrum hole.
3. Perichondrium: It is a connective tissue layer that covers the ear’s elastic cartilage.
4. Fat: The fat tissue from the earlobe may be used to repair the eardrum.
5. Cartilage: A small part of the patient’s cartilage may be used to patch a hole in the eardrum.

Risks

The complications associated with myringoplasty may include:

1. Hearing loss
2. Dizziness
3. Infection
4. Tinnitus (ringing sound in the ears)
5. Recurrent eardrum perforation
6. Graft failure leading to symptoms like infection, bleeding, altered taste
7. Ear numbness
8. Allergic reaction to the packing material
9. Scarring
10. Pain

After Procedure

1. Most patients go home on the same day following myringoplasty.
2. The patient can usually resume going to school or work one week after the surgery.
3. Complete recovery following myringoplasty may take one to two weeks.
4. You need to visit your doctor for a follow-up appointment about four to six weeks after myringoplasty.

Home remedies:

The following home remedies can be helpful in boosting the speed of recovery after myringoplasty:

1. Avoid water from entering your ear. Keep cotton with Vaseline into the ear while having a bath or taking a shower.
2. Take adequate rest.
3. Avoid alcohol or tobacco consumption.
4. Perform mild exercises regularly.
5. Take all your prescribed medicines on time.
6. Do not remove your bandage or dressing, except while putting the antibiotic ear drops in the ear canal.
7. Use your prescribed antibiotic ear drops on time.
8. Limit caffeine consumption.
9. Avoid blowing your nose.
10. If you must sneeze, do so with your mouth open for at least five to seven days after surgery.
11. Avoid the consumption of raw fruits, vegetables, or nuts that may be hard to chew.
12. Avoid swimming for a couple of weeks after surgery.
13. Strictly adhere to the follow-up appointments after surgery.

Cost of myringoplasty in India- 

The cost of myringoplasty in Mumbai is between INR 40,000 to INR 75,000.
The cost of myringoplasty in Delhi is between INR 35,000 to INR 70,000.
The cost of myringoplasty in Bangalore is between INR 35,000 to INR 70,000.
The cost of myringoplasty in Chennai is between INR 30,000 to INR 65,000.