Advice after your nerve block for surgery
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What is a Perforation?
A perforation of the ear drum is a hole through the ear drum into the middle ear. It sometimes allows water to get into the middle ear which may case infections. These lead to discharge from the ear, hearing loss and pain. The operation to repair the perforation is called a myringoplasty.
A perforation may be caused by a severe ear infection bursting the ear drum (most usually heal up) or an injury to the ear. Sometimes these conditions may damage the three small bones of the middle ear leading to hearing loss; repair of these bones is called an ossiculoplasty.
The Middle Ear:
Several important things are in the middle ear:
- The hearing mechanism – the three small bones that conduct sound into the inner ear are suspended in the middle ear and mastoid.
- The inner ear and balance organ – are in dense bone in the wall of the mastoid
- The facial nerve – this nerve controls the muscles on the same side of the face that make all the facial expressions. The nerve lies usually in a bony canal that crosses the middle ear and mastoid.
About The Operation:
This operation is usually carried out under general anaesthetic and can last 1-2 hours.
A cut may be necessary in the skin behind or above the ear.
The ear drum usually has to be peeled back to gain access to the middle ear and under surface of the ear drum.
A ‘graft’ (fibrous tissue) is taken from the surface of a muscle under the skin just above the ear. This graft is laid under the ear drum and held in place by packing. If repair of the bones is necessary, a piece of artificial bone is used to bridge the gap.
After The Operation:
- A head bandage may be used and it will be removed the morning after surgery
- Any stitches that need to come out will be removed after a week.
- A dressing will be left in the ear canal for one to two weeks.
- You will be able to go home on the same day or the day after the operation, but you will need to rest at home for about two weeks.
Pain - a headache around the ear is normal and you will need pain relief for up to ten days. This will be supplied to you on leaving hospital.
Discharge from the ear canal - Some discharge, often blood stained, is common in the first few days but then dries up.
Hearing - This will be muffled because of the packing in the ear and tinnitus is sometimes worsened temporarily.
Balance - This is sometimes disturbed but only for a few days.
The ear - This may stick out a little more and will also feel numb for a few weeks.
Out-patient appointment - This will either be given to you when you leave or will be sent on.
Post-Operative Instructions:
- Stay off work or school for a minimum of seven days but up to two weeks may be necessary. You can be given a sick note by the hospital if you need one – please ask for this before you leave the ward.
- Keep the ear and scar dry when washing. Cotton wool smeared in Vaseline is an effective ear plug. Avoid swimming until given the all clear.
- Change the cotton wool in the ear if it becomes dirty but be careful not to pull the dressing out with it – get someone to help. If some of the dressing is pulled out cut off the bit hanging out; if a whole piece comes out contact the ward.
- Minimise pressure changes in the ear - avoid vigorous nose blowing, sneeze with mouth open and don't fly.
- Complete any course of antibiotics you are given.
Risks:
- Failure of operation – placing a graft under the ear drum relies on it being incorporated into the body. Sometimes this does not happen and the repair fails leaving a persisting hole in the ear drum. The operation can be repeated if necessary. Repairing the three bones of the hearing mechanism may be unsuccessful leaving a persisting hearing loss. A hearing aid may still be considered. The structures in the middle ear (see above) can very rarely be damaged in the operation.
- Hearing – some hearing loss may occur from the disturbance to the bones of hearing in the middle ear. Very rarely, disturbance to the inner ear can cause complete deafness that is irreversible (only on the operated side). Tinnitus occasionally is worsened by the operation.
- Balance disturbance – immediately after the operation some unsteadiness may occur. Persisting dizziness is rare.
- Infection – can occur at the site of the skin cut or in the middle ear causing increased pain, discharge, swelling and fever; seek attention if you are concerned this may be developing.
- Taste disturbance – occasionally this is noticed usually only temporarily.
- Facial weakness – disturbance to the facial nerve occurs extremely rarely in this type of surgery and would cause weakness of the muscles of the face on the side of the operation. It may be either temporary or permanent.
If any of these problems arise after you have gone home please contact the wards:
Frimley Park Hospital: Short Stay Surgery ward Direct No: 0300 613 3216
F1 (children’s ward) 0300 613 4252
Any questions?
The team involved in your care have written this information page to make your admission and care as smooth as possible. However, it does not cover every aspect of your care and the staff will always be happy to answer any other questions or points of concern.
Please tell the surgeon about all medication you are taking especially warfarin, aspirin and/or the oral contraceptive pill.
Contact us
If you have any queries relating to this information, please contact the Ear or nose and throat (ENT) service.
About this information
Service:
Ear, nose and throat (ENT)
Reference:
G/043
Approval date:
23 February 2026
Review date:
1 February 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.