Myringoplasty is a surgery to repair a hole (perforation) in the eardrum. The eardrum is a thin, dime-sized piece of tissue sitting between your outer ear and middle ear, and when it has a hole that won’t close on its own, a surgeon patches it using a small graft of your own tissue. The goal is to seal the ear back up, restore hearing, and prevent recurring infections.
Why Eardrum Perforations Need Repair
Small eardrum tears from ear infections or minor trauma often heal on their own within a few weeks. Surgery becomes the conversation when a perforation has persisted for more than three months, whether it was caused by infection, injury, or a previous ear procedure. At that point, the body has likely stopped trying to close the gap.
An unrepaired hole creates two ongoing problems. First, sound vibrations can’t travel properly across a damaged eardrum, so hearing gradually worsens. Second, the middle ear is now exposed. Water from showering or swimming can seep through and trigger infections. Repeated middle ear infections raise the risk of more serious complications: vertigo, mastoiditis (infection of the bone behind the ear), and in severe cases, permanent hearing loss. Myringoplasty addresses all of these by physically closing the perforation.
Not everyone with a perforation needs surgery right away. If hearing loss is mild and infections are infrequent, some people manage by wearing earplugs during bathing and water activities to keep the middle ear dry. A hearing aid can also compensate for the hearing gap. But for people dealing with chronic or recurrent ear infections, progressive hearing loss, or the constant hassle of protecting the ear from water, repair is the more definitive solution.
How Myringoplasty Differs From Tympanoplasty
These two terms come up together often, and the distinction is straightforward. Myringoplasty repairs only the eardrum itself. Tympanoplasty is a broader procedure that repairs the eardrum and, when needed, reconstructs the tiny hearing bones (the malleus, incus, and stapes) in the middle ear. If the bones are intact and the only issue is the hole, myringoplasty is the simpler, more focused operation.
What Happens During the Procedure
The surgeon takes a small piece of your own tissue to use as a patch. The most common graft materials are fascia (a thin connective tissue layer harvested from just above the ear) and perichondrium (the tissue covering ear cartilage, typically taken from the tragus, the small flap of cartilage in front of your ear canal). Cartilage itself is sometimes used as well, particularly for larger perforations, because it’s stiffer and holds its shape well.
The graft is then positioned over or under the remaining eardrum to cover the hole. In the most common placement technique, called the underlay method, the graft sits on the inner side of the eardrum remnant. A modified approach layers cartilage on the inside while extending a flap of perichondrium over the outer surface, which helps prevent skin cells from getting trapped beneath the graft.
Endoscopic vs. Microscopic Approaches
Traditionally, surgeons used an operating microscope to view the eardrum, sometimes requiring an incision behind the ear to get adequate access. Newer endoscopic techniques use a thin camera inserted through the ear canal, eliminating the need for an external incision. A study comparing the two approaches found graft success rates of 96% with the endoscopic method and 92% with the microscopic method. Hearing improvement was essentially identical between the two, with both groups gaining roughly 11 decibels of hearing on average.
The practical advantages of the endoscopic approach are less pain after surgery, a shorter operation, and a better cosmetic result since the graft tissue is harvested through a small incision inside the ear rather than behind it. Both techniques work well, but endoscopic myringoplasty is increasingly becoming the standard at centers equipped for it.
What Recovery Looks Like
Myringoplasty is typically done as a day surgery, meaning you go home the same day. Expect the ear to feel full or plugged for several weeks while packing material inside the ear canal dissolves or is removed at a follow-up visit. Some temporary dizziness or mild discomfort is normal in the first few days.
The most important recovery rule is keeping water out of the ear. Even a small amount of water reaching the healing graft can introduce bacteria and jeopardize the repair. You’ll need to protect the ear during showers (a cotton ball coated in petroleum jelly works) and avoid swimming entirely until your surgeon confirms the graft has healed. Most people are advised to avoid swimming and submerging the ear for at least six to eight weeks, though the exact timeline varies.
Blowing your nose forcefully, flying, and heavy lifting are also typically restricted in the early weeks because they change pressure in the middle ear, which can stress the graft before it has fully integrated. Hearing may sound muffled at first due to swelling and packing, then gradually improves over one to three months as the graft settles and the eardrum regains its ability to vibrate normally.
Success Rates and What Can Go Wrong
Myringoplasty has a high success rate overall. Studies consistently report graft closure rates in the range of 85% to 96%, depending on the size and location of the perforation, the graft material used, and the surgical technique. Smaller perforations and those located centrally in the eardrum tend to have the best outcomes.
The most common complication is graft failure, where the patch doesn’t fully take and the hole reopens, either partially or completely. This is more likely if the ear develops an infection during healing or if the perforation was very large. When a graft fails, a second attempt at repair is possible and often successful.
Other potential complications include temporary changes in taste (a nerve that runs through the middle ear can be irritated during surgery), worsening of hearing rather than improvement, persistent tinnitus, and, rarely, dizziness that lasts beyond the first few days. Serious complications like permanent hearing loss are uncommon.
Who Is a Good Candidate
The ideal candidate has a dry, infection-free ear at the time of surgery. Active ear infections need to be treated and resolved before the procedure, because placing a graft into an infected environment dramatically increases the chance of failure. Most surgeons require the ear to be dry and free of discharge for several weeks before scheduling the operation.
Myringoplasty is performed in both adults and children, though in children, surgeons often wait until recurrent ear infections have settled down and the child is old enough that the immune system and ear anatomy are more mature. The procedure is also appropriate for people whose perforations resulted from trauma, such as a slap to the ear, a sudden pressure change, or an object pushed into the ear canal, as long as the hole hasn’t closed on its own after a reasonable waiting period.