Ear Problems and Endoscopic Ear Surgery
What ear discharge can tell us
- Watery: usually from the skin of the ear canal, and not serious
- Pus: infection of the outer or middle ear
- Sticky (mucoid): usually means a hole in the eardrum
Hearing loss
- Gradual hearing loss is common with age, as the hearing nerve weakens.
- Blockage of the ear canal, such as wax, can reduce hearing.
- A hole in the eardrum causes hearing loss.
Vertigo
Vertigo can come from the inner ear. Read more about vertigo.
When is ear surgery needed?
Most ear problems are treated with medicines first. Surgery is needed when a hole in the eardrum doesn't heal, the ear bones don't move properly, or there is disease eroding bone.
How is ear surgery done?
Using either a microscope or an endoscope, with very fine instruments. Most ear operations are done as day-care surgery.
Microscopic or endoscopic ear surgery?
Both give similar success rates. Microscopic surgery usually needs a cut behind or in front of the ear for access. Endoscopic surgery is done through the ear canal, and any small cut needed for the graft is placed in a hidden area.
What can be done endoscopically?
- Closing a hole in the eardrum (tympanoplasty), including endoscopic interlay tympanoplasty
- Draining fluid from the middle ear (myringotomy)
- Repairing the ear bones (ossiculoplasty)
- Removing limited bone-eroding disease (cholesteatoma)
Endoscopic interlay tympanoplasty
The eardrum has three thin layers. In the usual method (underlay), the graft that closes the hole is placed underneath the whole eardrum. In the interlay method, the graft is slipped between the outer skin layer and the middle layer of the eardrum, where it sits very securely.
- Done through the ear canal with an endoscope, so no cut is needed behind the ear for access.
- The graft is usually your own tissue (temporalis fascia), taken through a small cut hidden in the hairline. In selected small holes, PRF (a healing membrane made from your own blood) may be used.
- The method is chosen during surgery: interlay is used when the ear bones are working well. If they aren't, we use the underlay method and repair the ear bones at the same time.
- Usually done as day-care surgery.
Published studies of endoscopic interlay tympanoplasty report high rates of successful closure and good hearing results. It is technically demanding, so it is offered at relatively few centres.
A blocked or poorly working Eustachian tube can make holes in the eardrum come back. In selected patients, balloon Eustachian tube dilation may be advised as well.
How long is the rest after ear surgery?
Usually 4–6 weeks of avoiding strain and keeping water out of the ear. After myringotomy alone, no rest is needed.
Book a consultation
Call 81390 05150 or message on WhatsApp. See clinics and timings.