The ear is devided into 3 parts: the outer ear, the middle ear and the inner ear. The outer ear communicates with the ear and stops at the ear drum or tympanic membrane. The middle ear starts at the ear drum and houses the 3 bones of hearing (the Malleus, the Incus and the Stapes). It also connects to the mastoid bone behind the ear and the nose via a tube called the Eustachain tube. The inner ear is encased in hard bone and houses the Cochlea and the Balance organ (the vestibular apparatus).
A perforated ear drum can occur due to trauma or may result from chronic infection in the ear. Often a traumatic perforation can heal spontaneously but sometimes a perforation may not heal on its own. This maybe due to underlying ear disease such as chronic infections or presence of a choesteatoma. It may or may not be associated with erosion or destruction one or more of the three bones of hearing in the middle ear.
An ongoing perforation of the ear may cause recurrent discharge and infection and if the perforation is large and /or associated with disease of the bones of hearing may cause hearing loss.
A perforation can be surgically closed in an operation called a myringoplasty or tympanoplasty type1. However, depending on co-existing conditions in the ear, this operation may need to be conducted in conjuction with:
The primary goal of the repair is to give a safe, dry ear. Hearing restoration is also achieved but several factors, such as the state of the middle ear, scarring, eustachain tube function, state of the remaining ossicles all play a part in the final outcome of the hearing.