Tympanoplasty: diagnosis, function and long-term planning
Tympanoplasty is considered when a persistent eardrum perforation, retraction or middle-ear damage causes infection, drainage or conductive hearing loss.
The plan must distinguish a simple membrane defect from cholesteatoma, ossicular erosion, Eustachian-tube dysfunction or active infection because each changes access and hearing expectations.
Who may be considered?
Specialist review may help when a perforation does not heal, drainage recurs or conductive hearing loss affects daily life.
- A persistent traumatic or infectious eardrum perforation.
- Chronic ear discharge after medical treatment.
- Retraction or middle-ear disease requiring a stable barrier.
- A patient with realistic hearing and water-protection goals.
What the specialist team must confirm
Review otomicroscopy, pure-tone and speech audiometry, tympanometry when possible, culture during active drainage, temporal-bone CT for suspected cholesteatoma or ossicular disease and previous ear operations.
Key points for this treatment

From chronic perforation to a stable hearing ear
Surgical access, graft material and ossicular reconstruction depend on the location and condition of the remaining eardrum.
The graft needs protection while hearing settles
Packing, pressure precautions and keeping the ear dry are commonly required while the graft attaches.
Microscopy and audiometry document closure, middle-ear aeration and whether residual conductive loss needs further treatment.

Risks, limits and realistic expectations
Risks include graft failure, infection, altered taste, tinnitus, dizziness, persistent or worse hearing loss, facial-nerve injury and recurrent middle-ear disease.
Increasing pain, fever, facial weakness, severe vertigo, sudden hearing loss or persistent foul drainage requires urgent ENT review.
