Ear drum repair (Myringoplasty (type 1 tympanoplasty))
An operation to repair a persistent hole in the ear drum using a graft, to stop repeated infections, keep the ear dry and sometimes improve hearing.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- The operation patches a persistent hole in the ear drum to stop infections and let you get the ear wet more safely.
- It often closes the hole successfully, but it does not always work first time, and any hearing gain is not guaranteed.
- It is usually a day-case operation under general anaesthetic, with around two weeks off and the ear kept dry while it heals.
- Whether the graft has taken is usually known by about six to twelve weeks at follow-up.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Can close a persistent hole in the ear drum
An ear that is actively infected or discharging, where the infection should be controlled first.
Expect a packed ear, muffled hearing and mild discomfort. Rest, take simple painkillers, and keep the ear completely dry.
Clear instructions on keeping the ear dry, ear-drop use and what to avoid.
Expect a packed ear, muffled hearing and mild discomfort. Rest, take simple painkillers, and keep the ear...
Avoid getting the ear wet, blowing your nose hard, and strenuous activity. Many people take around two weeks off...
The packing is usually removed at a follow-up appointment. Hearing may still be muffled for a while as the ear...
The graft heals and whether the hole has closed becomes clear. Continue to protect the ear from water until told...
What is ear drum repair (myringoplasty)?
The ear drum is a thin membrane that separates the ear canal from the middle ear and helps you hear. A hole (perforation) can be left by infections, injury or previous grommets, and may cause repeated ear infections, the need to keep the ear dry, or some hearing loss.
Ear drum repair, called myringoplasty (or a type 1 tympanoplasty), patches the hole with a graft. The graft is usually a piece of the patient's own tissue, such as the lining over a muscle or a small piece of cartilage, placed against the drum so new tissue grows across the hole.
The main aims are to stop water getting into the middle ear and causing infections, to give a more reliable, healthy ear, and sometimes to improve hearing. It is mostly done when a perforation has not healed on its own and is causing problems. Hearing may improve if the hole closes, but the main purpose is often a safer, drier, infection-free ear rather than a guaranteed hearing gain.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Myringoplasty (type 1 tympanoplasty)
Repair of the ear drum alone, when the small bones of hearing are intact. This is the most common form of ear drum repair.
Graft material
The graft is usually the patient's own tissue — temporalis fascia (the lining over a muscle above the ear) or a thin piece of cartilage, which can be sturdier for larger...
Approach to the ear
The surgeon may work through the ear canal alone (permeatal), through a small cut just inside the canal (endaural), or through a cut behind the ear for better access to...
Tympanoplasty with ossicular work
If the tiny hearing bones are also damaged, a more involved tympanoplasty may be needed to repair them — this is a bigger procedure than a simple myringoplasty.
Preparing for your surgery
- Have your hearing tested beforehand so the result can be compared afterwards.
- Make sure the ear is as free of active infection and discharge as possible before surgery, as advised.
- Tell the team about all medicines, especially blood thinners, and any allergies.
- Arrange for a general anaesthetic, including following the fasting instructions you are given.
- Plan for around two weeks off work and a lift home, as you cannot drive immediately after a general anaesthetic.
- Be ready to keep the ear completely dry for several weeks, so plan hair washing and bathing around this.
- Avoid flying around the time of surgery if advised, because of pressure changes.
What happens
The operation is usually done under general anaesthetic, so you are asleep, and takes around one to two hours. The surgeon reaches the ear drum through the ear canal, or through a small cut just inside or behind the ear if better access is needed, leaving little or no visible scar.
A graft of your own tissue is taken and placed against the hole in the drum, supported by dissolvable dressing material in the ear canal and middle ear. The new tissue then grows across the graft to close the hole over the following weeks.
Most people go home the same day. The ear is packed and you are given instructions to keep it dry. The packing is usually removed at a follow-up appointment a couple of weeks later, and whether the graft has taken is generally clear by around six to twelve weeks.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- An ear that is actively infected or discharging, where the infection should be controlled first.
- A very small perforation that is likely to heal on its own with time and ear protection.
- People for whom a general anaesthetic is too risky, where the benefit may not justify it.
- Where the hearing loss is due to other problems (such as the hearing bones or inner ear) that repairing the drum alone will not fix.
Delay surgery if…
- The ear is currently infected or discharging.
- There is an active cold or upper-airway infection around the planned date.
- Blood thinners need adjusting and a safe plan has not been agreed.
- You have upcoming flights or diving that would expose the healing ear to pressure changes.
Alternatives to discuss
- Watchful waiting, as some perforations heal by themselves over time.
- Keeping the ear dry and treating infections as they arise, without surgery.
- A hearing aid to manage hearing loss if surgery is not wanted or suitable.
- An ear-mould or water-protection plan for swimming and washing instead of repair.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Can close a persistent hole in the ear drum
- Reduces repeated middle-ear infections
- Lets you get the ear wet more safely, for example when swimming or washing hair
- May improve hearing if the hole closes
- Gives a more stable, healthier ear in the long term
Risks & complications
- A dressing or packing in the ear and muffled hearing until it is removed and healed
- Mild discomfort and a feeling of fullness in the ear
- Temporary altered taste on one side of the tongue (from a nerve close to the ear drum)
- A small wound just inside or behind the ear if that approach is used
- The graft not taking, so the hole stays open or comes back and may need repeat surgery
- Infection of the ear or wound
- Dizziness for a short time after surgery
- Tinnitus (noises in the ear)
- Hearing not improving, or rarely becoming slightly worse
- Total, permanent hearing loss in the operated ear
- Weakness of the face on that side from injury to the facial nerve, which runs close by
- Persistent taste disturbance or persistent dizziness
The main uncertainties are whether the graft will take and whether your hearing will improve. Success is less likely with very large holes, a still-infected or discharging ear, or in younger children. Serious risks such as total hearing loss or facial nerve injury are rare but important, because the facial and hearing structures lie close to the ear drum. Ask your surgeon about your personal chance of the hole closing, what they expect for your hearing, and what happens if the graft does not take.
Published figures to discuss
Ear drum repair has good success rates in suitable ears, but the chance of the hole closing depends on its size and position, whether the ear was dry and free of infection, the graft used and the patient's age. Hearing outcomes are separate from closure: closing the hole does not always change hearing, because hearing also depends on the middle-ear bones and the inner ear. Serious complications are rare but important.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Closure of the perforation (graft takes) | UK national standard around 89.5%; commonly quoted 80–90% | Lower for very large holes, an ear that was still infected, and in children under about 13. | Myringoplasty outcomes (perforation size and success) — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Closure by perforation size | Higher for small holes than for holes larger than half the drum | Studies report better closure for smaller perforations; large or marginal holes are more challenging. | Myringoplasty outcomes (perforation size and success) — PMCpmc.ncbi.nlm.nih.govSource-linked context |
| Serious hearing or facial nerve complications | Rare | Total hearing loss and facial weakness are uncommon but recognised risks given the nearby structures. | Myringoplasty outcomes (perforation size and success) — PMCpmc.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery is usually straightforward but needs patience, mainly because the ear must be kept dry and hearing stays muffled until the packing is removed and the graft heals.
- Muffled hearing in the operated ear until packing is removed and healing completes
- A feeling of fullness, mild discomfort or occasional sharp twinges
- A change in taste on one side of the tongue that usually settles over weeks
- Keeping the ear dry for several weeks
- A small, well-hidden wound if the surgeon worked behind or inside the ear
Aftercare
- Keep the ear completely dry until your surgeon says it is safe — use cotton wool coated in petroleum jelly when washing your hair, as advised.
- Do not put anything else into the ear and do not remove the packing yourself.
- Avoid blowing your nose hard; sneeze with your mouth open to protect the repair.
- Avoid swimming, strenuous exercise and heavy lifting until cleared.
- Take any prescribed ear drops and painkillers as directed.
- Avoid flying until your surgeon confirms it is safe, because of pressure changes.
- Attend the follow-up appointments to have the packing removed and the result checked.
- Cotton wool and petroleum jelly for keeping the ear dry when washing
- Around two weeks off work arranged
- A lift home after the general anaesthetic
- Prescribed ear drops and painkillers collected
- Follow-up appointments for packing removal and hearing test noted
- The clinic's contact number for problems
Scars and how they heal
If the surgeon works through the ear canal, there is no visible scar. If a cut is made just inside the canal or in the crease behind the ear, any scar is usually small and well hidden. If a graft is taken from above the ear, there is a small scar there, often hidden in the hairline.
⚠ Get urgent help if…
- Sudden or significant worsening of hearing in the operated ear
- Weakness or drooping of the face on the operated side — seek urgent help
- Severe or spinning dizziness, especially with vomiting
- Increasing pain, swelling, redness or discharge from the ear (signs of infection)
- A high temperature or feeling generally unwell
- Bleeding from the ear that does not settle
- Severe headache or neck stiffness — seek urgent help
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result is a healed ear drum with the hole closed, fewer or no infections, and an ear you can get wet more safely. If hearing was reduced because of the hole, it may improve once the drum is repaired, though the main aim is often a safe, dry, healthy ear.
Closing the hole is not guaranteed. The graft sometimes fails to take, particularly with larger holes or an ear that was still infected, and a repeat operation may be needed. Hearing usually stays the same or improves, but occasionally does not change or, rarely, gets slightly worse. Your surgeon will compare your hearing tests before and after to judge the outcome.
When the graft takes, the repair is usually long-lasting and the ear drum behaves like a normal one. Future ear infections, injury or pressure problems can occasionally affect it, and a small number of perforations re-open over time. Keeping the ear healthy and getting prompt treatment for infections helps protect the result.
Combining with other procedures
Ear drum repair is sometimes combined with treatment of the middle ear or the small hearing bones if they are also affected, which makes it a larger tympanoplasty. It may follow treatment to settle an infected or discharging ear first. A hearing test is always part of the assessment and follow-up.
Follow-up & long-term care
You will usually be seen at around two weeks to remove the packing, and again at around six to twelve weeks to check whether the graft has taken. A repeat hearing test assesses any change in hearing. If the hole has not closed, your surgeon will discuss options, including a further repair.
- Keeping the ear dry until cleared, then protecting it during swimming if advised
- Prompt treatment of any future ear infections
- Avoiding poking or cleaning inside the ear canal
- A hearing review if hearing changes in future
Revision and secondary surgery reality
- The graft does not always take, and a repeat repair is sometimes needed, more often with large holes.
- Hearing may not improve even when the hole closes, if the problem also involves the hearing bones or inner ear.
- A small number of repaired drums re-perforate over time.
- If the hearing bones are involved, a further or more complex operation may be required.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Clear instructions on keeping the ear dry, ear-drop use and what to avoid.
- A named contact and route for problems such as discharge, dizziness or facial weakness.
- Follow-up to remove packing and to confirm whether the graft has taken.
- A repeat hearing test to measure the result against the pre-operative test.
- An honest plan for further surgery if the perforation has not closed.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The surgeon's fee, which varies with the size of the hole and the approach
- General anaesthetic and theatre or facility fees
- Whether the small hearing bones also need work (a larger tympanoplasty)
- Hearing tests before and after surgery
- Follow-up appointments to remove packing and check the result
- Any repeat surgery if the graft does not take
- The surgeon's fee and what the operation includes
- The facility or theatre fee and the anaesthetic fee
- Whether hearing tests before and after are included
- The cost and timing of follow-up appointments
- What happens, and what it costs, if the graft does not take and repeat surgery is needed
- Whether any work on the hearing bones is included or charged separately
- The cancellation policy
On the NHS? Ear drum repair is available on the NHS when clinically indicated for recurrent infections, the need to keep the ear dry, or hearing loss; private care is mainly chosen for speed or choice of surgeon.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Promising the hole will definitely close, when success depends on size, infection and age.
- Implying hearing will certainly improve, when closure and hearing are separate outcomes.
- Not mentioning the rare risks of total hearing loss or facial nerve injury.
- Not explaining the need to keep the ear dry and to avoid flying while it heals.
- No clear plan for what happens if the graft does not take.
Marketing red flags
- Claiming guaranteed closure or guaranteed hearing improvement.
- Describing the operation as without risks or trivial.
- Not discussing the chance of needing a repeat operation.
- Quoting success rates without relating them to your hole size, ear and age.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- What is my personal chance of the hole closing?
- Do you expect my hearing to improve, and by how much?
- Which approach and graft will you use, and why?
- What happens if the graft does not take?
- How long must I keep the ear dry and avoid flying?
- How will you check the result, and when?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will my hearing definitely improve?
How successful is the operation?
Can I get it on the NHS?
How long do I need off work?
Why does my taste feel odd afterwards?
Can I fly after the operation?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Perforated eardrum ENT UK — patient information Royal Berkshire NHS — Myringoplasty/Tympanoplasty leaflet Dorset County Hospital NHS — Myringoplasty/Cartilage tympanoplasty Myringoplasty outcomes (perforation size and success) — PMC Myringoplasty vs type 1 tympanoplasty: systematic review — PubMed
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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