Myringoplasty Surgery in Singapore

Living with a perforated eardrum can impact quality of life, potentially causing hearing difficulties, recurring ear infections, and restrictions on water activities. If you’re experiencing these challenges, myringoplasty surgery offers an established treatment option for repairing eardrum perforations and supporting ear function. This surgical procedure aims to help patients regain hearing clarity and return to normal activities. Our ENT Specialists perform myringoplasty using current techniques tailored to each patient’s specific condition. Individual results and timelines may vary.

Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

Image doctor with human ear anatomy model ear disease 2025 03 05 04 32 55 utc

Overview Candidates Treatment Process Recovery Benefits Risks Cost FAQ

What is Myringoplasty Surgery?

Myringoplasty is a surgical procedure that repairs holes in the tympanic membrane (eardrum). This microsurgical technique uses a tissue graft to close the hole and restore the eardrum’s structure. The procedure treats holes caused by chronic ear infections, trauma, or complications from previous ear surgery.

The surgery aims to achieve several key goals: closing the eardrum hole to prevent water and bacteria from entering the middle ear, improving hearing by restoring the eardrum’s ability to vibrate properly, and reducing the risk of chronic ear infections. During myringoplasty, ENT specialists use specialised microscopes and precision instruments to carefully position graft material over or under the hole, allowing natural healing to incorporate the graft into the eardrum structure.

The procedure treats various types of eardrum holes, from small traumatic tears to larger holes from chronic otitis media. Myringoplasty may be effective when performed by experienced ENT specialists, with outcomes depending on factors such as hole size, location, and the patient’s overall ear health.

Who is a Suitable Candidate?

Ideal Candidates

Suitable candidates for myringoplasty surgery typically meet several criteria:

Patients with persistent eardrum perforations that have not healed naturally
Individuals experiencing conductive hearing loss due to eardrum perforation
Those with recurrent ear infections related to the perforation
Patients who need to avoid water entering their ears during bathing or swimming
Adults and children with adequate eustachian tube function
Individuals with dry ears (no active infection) before surgery
Patients committed to following post-operative care instructions
Those seeking to address concerns related to eardrum perforation

Contraindications

Certain conditions may make myringoplasty unsuitable or require special consideration:

Active ear infection or discharge that needs treatment before surgery
Poor eustachian tube function causing persistent negative middle ear pressure
Only hearing ear with significant sensorineural hearing loss
Cholesteatoma requiring more extensive surgical intervention
Severe scarring or absence of suitable graft donor sites
Medical conditions that significantly increase surgical risks
Young children whose eustachian tubes are still developing

Our ENT Specialists conduct comprehensive assessments, including hearing tests, ear examinations, and sometimes CT scans, to determine if myringoplasty may be an appropriate treatment option for your specific situation.

Treatment Techniques & Approaches

Transcanal Approach

The transcanal approach accesses the eardrum through the ear canal without external incisions. This technique may be suitable for smaller perforations in favourable positions. The ENT specialist works through the natural ear canal using an operating microscope or endoscope, making this approach less invasive with minimal visible scarring. This method may result in faster recovery times and less post-operative discomfort.

Postauricular Approach

The postauricular approach involves making an incision behind the ear to access the eardrum. This technique can provide better visualisation and access for larger perforations or those in difficult locations. The scar remains hidden in the natural crease behind the ear. This approach allows ENT specialists to harvest temporalis fascia graft material through the same incision, making it efficient for complex repairs.

Endoscopic Ear Surgery

Endoscopic myringoplasty uses specialised endoscopes instead of traditional microscopes for visualisation. This contemporary technique can offer visualisation of the entire eardrum and middle ear structures through the ear canal. The endoscope’s angled views allow ENT specialists to see areas that might be hidden with microscopic techniques.

Graft Materials and Placement Techniques

Various graft materials can be used for eardrum repair, including:

Temporalis fascia (tissue from the muscle above the ear)
Cartilage with or without perichondrium
Fat grafts for small perforations
Occasionally, synthetic materials

The graft may be placed using an underlay technique (beneath the eardrum remnant) or overlay technique (on top of the eardrum), depending on the perforation characteristics and ENT specialist preference.

Wondering which approach might be suitable for you?

Our ENT Specialist can evaluate your specific needs and discuss the available techniques.

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The Treatment Process

Pre-Treatment Preparation

Before your myringoplasty surgery, several preparatory steps may help ensure appropriate conditions for the procedure. You’ll undergo audiometry (hearing tests) to document your baseline hearing levels and assess the degree of conductive hearing loss. Blood tests may be required to check your general health status. Your ENT specialist will review your medications, as certain blood thinners may need temporary discontinuation.

In the days before surgery, you’ll receive specific instructions about fasting requirements, typically no food or drink after midnight before morning surgery. Arrange for someone to drive you home after the procedure, as you won’t be able to drive immediately following anaesthesia. Stop smoking at least two weeks before surgery if applicable, as smoking can impair healing.

During the Procedure

Myringoplasty surgery typically takes a certain duration, though complex cases may require more time. The procedure begins with administration of anaesthesia – either general anaesthesia or local anaesthesia with sedation, depending on patient age and preference. Once you’re comfortable, the ENT specialist positions you appropriately and prepares the surgical site.

Using the chosen approach, the ENT specialist carefully freshens the perforation edges to promote healing, then harvests graft material if using autologous tissue. The graft is positioned and secured using absorbable gelatin sponge or other supporting materials. The ear canal is then packed with antibiotic-soaked material to hold everything in place during initial healing.

Immediate Post-Treatment

After surgery, you’ll recover in the post-anaesthesia care unit where nurses monitor your vital signs and comfort level. Patients may experience minimal pain, though mild discomfort or fullness in the ear is normal. You may feel slightly dizzy initially, which typically resolves within hours. Discharge usually occurs the same day for many patients, though some may stay overnight for observation.

Before leaving, you’ll receive detailed instructions about ear care, medications including antibiotics and pain relievers, and warning signs to watch for. The ear packing and any external bandaging will be explained, along with how to keep them dry and intact.

Recovery & Aftercare

First 24-48 Hours

The initial recovery period requires careful attention to prevent complications. Keep your ear absolutely dry – use a cotton ball with petroleum jelly when showering. Rest with your head elevated to reduce swelling and avoid any pressure on the operated ear. Take prescribed antibiotics as directed to prevent infection and use pain medication as needed.

Avoid nose blowing, sneezing with the mouth closed, or any straining that could create pressure in the ears. Some bloody or yellowish discharge from the ear is normal initially. Monitor for excessive bleeding, severe pain, or high fever, which should prompt immediate medical attention.

First Week

During the first week, continue keeping the ear dry and protected. You can usually return to desk work, but should avoid strenuous activities. Sleep on the unoperated side and avoid air travel or altitude changes. Your follow-up appointment will be scheduled to check the packing and assess initial healing.

Hearing may seem muffled due to packing material in the ear canal – this is temporary and expected. Continue all prescribed medications and maintain careful ear hygiene as instructed.

Long-term Recovery

Healing of the eardrum may take several weeks. Packing materials are usually removed during a follow-up visit. Once packing is removed, hearing improvement may become noticeable, though recovery timelines vary as the eardrum continues healing.

Activity restrictions gradually lift over time as healing progresses. Swimming and water sports should be avoided until your ENT specialist confirms complete healing. Air travel timing will be determined by your ENT specialist based on your individual healing progress. Regular follow-up appointments monitor healing progress, with hearing tests repeated to document any improvement.

Our ENT Specialist provides post-procedure support to help with recovery.

Schedule your consultation to learn more about what to expect.

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Benefits of Myringoplasty Surgery

Myringoplasty surgery may offer improvements in the quality of life for patients with eardrum perforations. The primary benefit is potential restoration of hearing, with patients potentially experiencing improvement in their conductive hearing loss once healing is complete. This hearing improvement can enhance communication, work performance, and overall social engagement.

The procedure aims to eliminate the risk of water entering the middle ear, allowing patients to shower, swim, and participate in water activities without special ear protection. This freedom from constant ear protection may improve daily convenience and allow return to previously restricted activities.

By closing the perforation, myringoplasty may reduce the risk of middle ear infections. Patients who previously suffered from recurrent ear infections might find resolution of this problem. The intact eardrum can provide a barrier against bacteria and debris, protecting the delicate middle ear structures.

Additional benefits may include elimination of ear discharge, reduced tinnitus in some cases, and improved ear comfort during air travel or altitude changes. Patients might experience psychological benefits from resolving a long-standing medical condition and regaining normal ear function. Individual results and timelines may vary. This treatment is administered as part of a comprehensive plan supervised by a healthcare professional.

Risks & Potential Complications

Common Side Effects

Patients may experience temporary side effects that can resolve during normal healing. Mild ear pain or discomfort may occur and can be treated with over-the-counter pain medication. Temporary hearing reduction may occur due to ear packing and swelling, and may improve once packing is removed. Some patients may experience mild dizziness or imbalance after surgery.

Temporary changes in taste may occur if the chorda tympani nerve is manipulated during surgery, and may resolve over time. Minor bleeding or discharge from the ear may be normal initially. These effects can be managed with appropriate medications.

Potential Complications

Potential complications may include graft failure, where the perforation doesn’t close completely and may require revision surgery. Hearing may worsen due to scarring or damage to the middle ear structures. Facial nerve injury is possible, potentially causing temporary or permanent facial weakness.

Infection of the graft or middle ear may occur and typically responds to antibiotic treatment. Some patients may develop chronic ear drainage despite graft placement. Cholesteatoma formation is a potential long-term complication that may require additional surgery.

Risk management involves choosing an ENT specialist, following pre- and post-operative instructions carefully, and attending all follow-up appointments. Modern surgical techniques and equipment aim to minimise complication risks. Individual results and outcomes may vary. This information is provided for educational purposes and does not replace professional medical consultation.

Cost Considerations

The cost of myringoplasty surgery in Singapore varies based on several factors. The complexity of your perforation, including its size and location, affects the surgical time and technique required. The choice between day surgery and overnight admission impacts facility fees. The type of anaesthesia selected and the specific surgical approach used also influence costs.

Surgical fees typically include the ENT specialist’s fee, anaesthesiologist charges, operating theatre costs, and hospital or day surgery centre fees. Post-operative care, including medications, follow-up consultations, and hearing tests, represents additional considerations. Some patients may require pre-operative CT scans or special investigations.

Choosing an ENT specialist may help reduce the likelihood of revision surgery. Quality surgical technique and comprehensive care can provide value for patients. During your consultation, you’ll receive a detailed cost estimate tailored to your specific surgical requirements and chosen facility.

For Singaporeans & Singapore Permanent Residents

Medisave & Insurance Shield Plan approved

Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.

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Frequently Asked Questions (FAQ)

How long does myringoplasty surgery take to perform?

Myringoplasty surgery may take varying amounts of time to complete, depending on factors including perforation size, chosen surgical approach, and whether graft material needs harvesting. Your ENT specialist will provide a time estimate based on your specific case during the pre-operative consultation.

When can I return to work after myringoplasty?

Return to work timing varies by individual and job requirements. Patients with desk jobs may be able to return within several days after surgery, while those with physically demanding jobs may need to wait longer before returning to heavy lifting or strenuous activities. Your return to work timing also depends on your comfort level and whether your work environment is dusty or requires ear protection.

Will I regain normal hearing after surgery?

Hearing improvement may occur after myringoplasty, particularly if hearing loss was primarily due to the perforation. Hearing changes typically develop gradually as the eardrum heals and middle ear function stabilises. The degree of improvement depends on factors including perforation size, duration of the problem, and presence of other ear conditions. Your pre-operative hearing test helps predict potential improvement.

Can children undergo myringoplasty surgery?

Children can undergo myringoplasty, though ENT specialists may prefer waiting until the eustachian tube function matures. Some ENT specialists may operate on younger children in specific circumstances, such as hearing loss affecting speech development or recurrent severe infections. Paediatric cases can have good outcomes when timing is appropriate and post-operative care instructions are followed carefully.

What happens if the graft fails?

Graft failure can occur, meaning the perforation doesn’t close completely or reopens after initial healing. If this happens, revision myringoplasty can be performed, usually after waiting for complete healing from the first surgery. Your ENT specialist will investigate causes of failure to optimise the revision approach.

How soon can I fly after myringoplasty surgery?

Air travel timing depends on your healing progress and your ENT specialist’s assessment. Some patients may be cleared for flying once initial healing is established. During early flights, you might experience mild ear discomfort during altitude changes. Using decongestants before flying and performing gentle ear-popping exercises can help equalise pressure safely.

Will I need to protect my ear from water permanently?

Once your ENT specialist confirms complete healing, many patients no longer need water precautions for routine activities like showering or swimming in clean pools. However, some ENT specialists recommend continued protection when swimming in potentially contaminated water like lakes or oceans. Deep diving may require special consideration even after surgery.

Can myringoplasty be performed under local anaesthesia?

Myringoplasty can be performed under local anaesthesia with sedation in cooperative adult patients, particularly for smaller perforations using the transcanal approach. This option may reduce anaesthesia risks and allow faster recovery. However, general anaesthesia may be preferred for children, anxious patients, or complex cases requiring longer operative time. Your ENT specialist will discuss the most appropriate anaesthesia option based on your specific situation and preferences.

Conclusion

Myringoplasty surgery offers a treatment option for repairing eardrum perforations and may help restore ear function. For many patients, the procedure can address the limitations caused by a perforated eardrum, with potential benefits including improved hearing, reduced risk of recurrent infections, and overall enhancement of ear function.

If a perforation is affecting your hearing or daily comfort, consulting an ENT Doctor in Singapore can help determine whether myringoplasty is suitable for your condition. Modern surgical techniques and structured post-operative care may support successful healing and favorable outcomes. This procedure is performed as part of a comprehensive treatment plan guided by a qualified healthcare professional.

Ready to Take the Next Step?

If you’re considering myringoplasty surgery, our ENT Specialist can help you understand if it’s the right choice for your needs. With experience in eardrum repair procedures, we provide personalised care throughout your journey.

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Dr Gan Eng Cern

Ear, nose and throat specialist

MBBS

MRCS (Edin)

mmed (orl)

FAMS

With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.

Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He underwent his subspecialty training in Rhinology (Nose & Sinus conditions) and Endoscopic Skull Base Surgery at the renowned St Paul’s Sinus Center, part of the University of British Columbia in Vancouver, Canada. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.

2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
2016 – Best Educator Award (Eastern Health Alliance)
2016 – “Wow” Award (Patient Compliment)

2014 – Eastern Health Alliance Caring Award – Silver
2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
2012 – Human Manpower Development Award (Ministry of Health, Singapore)
2007 – Singhealth Best Doctor Award

Qualifications

MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
FAMS – Fellow of the Academy of Medicine Singapore

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A Specialist Clinic for Sinus, Snoring & ENT

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Mount Elizabeth Novena Hospital
Singapore 329563

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