The ear drum (also known as the tympanic membrane) is the thin layer of skin that covers the deeper air-containing space called the middle ear. It is a barrier to external objects entering the ear. It serves to ‘focus’ the sound energy to the Ossicular chain. This is a chain of 3 bones that conduct the sound energy through the middle ear to the inner ear where the nerve endings are located. The 3 bones are (in order from external to internal): Malleus, Incus and Stapes.
An opening or perforation in the tympanic membrane can result in hearing loss by interfering with the normal transfer of sound to the ossicular chain. Perforations typically occur from injury or repeated infections. At times the ossicular bones may be damaged or dislocated causing a disruption of sound energy transmission and thus a conductive hearing loss.
By repairing the tympanic membrane and/or the ossicular bones, the normal conductive mechanism can be re-established and hearing loss improved.
Surgery for Perforation: Tympanoplasty
Surgery to repair the ear drum is termed Tympanoplasty and may or may not include repair of the ossicles (ossicular chain reconstruction). This surgery typically requires a graft of your own tissues. This ‘patch’ is usually taken from behind the ear leaving a small scar.