Does a perforated eardrum need surgery?

Question

Hi doctor,

I am 23-years-old male, with a height of 5'7", and my weight is 110.23 lb. I have an infection in my right ear. A discharge keeps on coming out. It first happen during childhood. It used to happened during the winter alone and lasts for two to three weeks. I use earphones a lot. But it did not affect my left ear, so there must be a problem with my right ear. But when I stop using them, it gives relief. For more than a year now, my ear has worsened. It continuously discharges. I have to put cotton bud all the time. I am frustrated and worried. My E.N.T specialist told me that surgery is the option as my eardrum has ruptured. They did say that before. I have had many visits over there. But last time, the doctor told me about the procedure and that an incision is made from behind the ear, and the eardrum is patched using the skin. I was scared a little that it might cause more damage. However, the doctor said the success rate is like 90 percent. I had to think. And my procrastination is another problem. I left it till the end, did not get my ear checked. So what should I do? I cannot hear very well, especially when pus comes out from the right ear. When I clear it, my ear gets a little better, but not like my left ear. I do not want to lose my hearing or damage my ear. Should I proceed with the surgery? As I heard there, are there any other surgeries that operate from the outside rather than making an incision? Please advise and help me. Thank you very much.

Answer 1

Hi,

Welcome to icliniq.com.

Thanks for the briefing regarding the problem in concern. Eardrum perforation causing intermittent ear discharge is a frustrating problem and has to be treated systematically. Most importantly, it is necessary to treat the triggering factors to the ear discharge. If the triggering or contributing factors have not been treated, the ear discharge might continue even after the surgery. There are few scenarios that you need to understand. 1) If there are any nasal allergies, it has to be controlled as much as possible before the surgery is performed. 2) If there has been a good response to antibiotics and the ear is dry for atleast three weeks, you can go ahead with a plain surgery called tympanoplasty. 3) If there has been consistent ear discharge even after the appropriate antibiotics from the culture sensitivity of the ear discharge and if you have an eardrum perforation with no other problems, then you will have to do an HRCT (high resolution computed tomography) of the temporal bone and undergo a minimum cortical mastoidectomy and tympanoplasty depending on the extent of the disease. 4) A pure tone audiometry is a must before surgery to ascertain the extent and type of your hearing loss. A sensorineural hearing loss cannot be reversed, but a conductive hearing loss can be reversed to a good extent. 5) A plain tympanoplasty surgery can be done with an incision behind the ear called the post aural approach using William Wilde's incision. We can do the entire procedure endoscopically without any incision behind the ear. In the endoscopic technique, a small incision is usually placed inside the tragus to harvest a graft and is closed with not more than three small sutures. The entire procedure takes around 45 minutes to one hour, depending on the experience and expertise of the operating surgeon, and can be done under local anesthesia or general anesthesia. It has a success rate of somewhere between 85 to 95 %. 6) Your conductive hearing loss should improve if the procedure has been done diligently. I hope this answers your query. Warm regards.

Does a perforated eardrum need surgery?

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