# Myringoplasty

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Surgical operation in the ear

Medical intervention

Myringoplasty Specialty Otorhinolaryngology [edit on Wikidata]

**Myringoplasty** is the closure of the perforation of pars tensa of the [tympanic membrane](/source/Tympanic_membrane).[1][2][3] When myringoplasty is combined with removal of scar tissue, it is called [tympanoplasty](/source/Tympanoplasty). The operation is performed with the patient supine and face turned to one side. The graft material most commonly used for the surgery is temporalis fascia. The tragal cartilage[1] and tragal perichondrium are also used as the graft by some surgeons.

Myringoplasty restores hearing loss in certain cases of [tinnitus](/source/Tinnitus). The chances of re-infection and persistent discharge is less after surgery. Myringoplasty should not be performed if there is active discharge from the [middle ear](/source/Middle_ear), or if the patient has uncontrolled nasal allergy, or when the other ear is dead and in children less than 3 years of age. Myringoplasty is often done under [general anaesthesia](/source/General_anaesthesia), but it can be done under local anaesthesia also.

## Technique of surgery

### Underlay technique

The [temporalis fascia](/source/Temporalis_fascia) is grafted. An incision is made along the edge of the perforation and a ring of epithelium is removed. A strip of mucosal layer is removed from the inner side of the perforation. The middle ear is packed with [gelfoam](/source/Gelfoam) soaked with an [antibiotic](/source/Antibiotic).[2] The edges of the graft should extend under the margins of the perforation and a small part should also extend over the posterior canal wall. The tympanomeatal flap is then replaced.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

### Overlay technique

The temporal fascia is harvested. An incision is made to raise medial meatal skin with [tympanic membrane](/source/Tympanic_membrane) epithelium. The graft is placed on the outer surface of the tympanic membrane and a slit is made to tuck it under the handle of the [malleus](/source/Malleus). The ear is packed with gelfoam and antibiotics,[2] and the incision is closed. Finally [mastoid dressing](https://en.wikipedia.org/w/index.php?title=Mastoid_dressing&action=edit&redlink=1) is performed.

## Advantages

- Restores the hearing loss and in some cases, [tinnitus](/source/Tinnitus).

- Checks the re-infection from external auditory canal and [eustachian tube](/source/Eustachian_tube).

- Checks [aeroallergens](/source/Allergen) reaching the exposed middle ear mucosa, leading to persistent ear discharge.

## Contraindications

- Active discharge from the middle ear

- Nasal allergy, which should be controlled before surgery

- When the other ear is dead or not suitable for hearing

- [Otitis externa](/source/Otitis_externa)

- Children below 3 years

## See also

- [Tympanoplasty](/source/Tympanoplasty)

- [Myringotomy](/source/Myringotomy)

## References

1. ^ [***a***](#cite_ref-glennwatson_1-0) [***b***](#cite_ref-glennwatson_1-1) Watson, Glenn. ["Myringoplasty repairs a hole in the tympanic membrane"](https://web.archive.org/web/20121221014726/http://www.glennwatson.com.au/Myringoplasty.html). Glenn Watson Pty. Archived from [the original](http://www.glennwatson.com.au/Myringoplasty.html) on 21 December 2012. Retrieved 13 August 2012.

1. ^ [***a***](#cite_ref-entsurgeon_2-0) [***b***](#cite_ref-entsurgeon_2-1) [***c***](#cite_ref-entsurgeon_2-2) ["Operations and Procedures: Myringoplasty"](https://web.archive.org/web/20120110134546/http://www.ent-surgeon.co.uk/operations/myringoplasty.htm). ENT Surgeon. Archived from [the original](http://www.ent-surgeon.co.uk/operations/myringoplasty.htm) on 10 January 2012. Retrieved 13 August 2012.

1. **[^](#cite_ref-Rozendorn_2016_3-0)** Rozendorn, Noa; Wolf, Michael; Yakirevich, Arkadi; Shapira, Yisgav; Carmel, Eldar (November 2016). "Myringoplasty in children". *International Journal of Pediatric Otorhinolaryngology*. **90**: 245–250. [doi](/source/Doi_(identifier)):[10.1016/j.ijporl.2016.09.024](https://doi.org/10.1016%2Fj.ijporl.2016.09.024). [ISSN](/source/ISSN_(identifier)) [0165-5876](https://search.worldcat.org/issn/0165-5876). [PMID](/source/PMID_(identifier)) [27729143](https://pubmed.ncbi.nlm.nih.gov/27729143).

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Adapted from the Wikipedia article [Myringoplasty](https://en.wikipedia.org/wiki/Myringoplasty) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Myringoplasty?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.