Ear Surgery - A guide to Hearing Loss

There is a range of different surgical procedures available to treat hearing loss which in some cases is the only means of restoring normal hearing.

The majority of ear surgery is performed as ‘microsurgery’: this involves the surgeon using a special microscope in the operating theatre to have a close up view of the structures of the ear.

Examples of ear surgery include:

  • Mastoidectomy
  • Myringoplasty
  • Myringotomy
  • Stapedectomy
  • Tympanoplasty

Other procedures include the removal of ear tumours such as cholesteatoma, and reconstructive surgery for a congenital ear defect, for example congenital atresia.

What to expect

Ear surgery is a big deal whether you are a day case or an in-patient in hospital. Your surgery will be carried out by a qualified and experienced ear, nose and throat (ENT) surgeon who will have taken a full medical history beforehand. He/she will have also discussed your procedure with you, highlighting the benefits as well as pointing out the risks.

He or she tell you if the procedure will restore your hearing back to normal or whether it is a case of preventing any further deterioration.

If you are going to have a general anaesthetic then there are guidelines to be followed before surgery which include when to have your last meal, what will happen on the day and post-surgery.


This is the removal of a skin growth or infection (mastoiditis) of the mastoid bone. This is usually carried out if medical treatment has proved unsuccessful.

If this infection is left unchecked then it can spread to surrounding areas such as the brain and cause long term hearing loss.


This is carried out if a perforated ear drum fails to heal by itself.

An ear drum can become perforated, often as a result of an ear infection, sudden exposure to a loud noise, the presence of a foreign body or by pushing a cotton wool bud too far into the ear. Most cases the ear drum will seal itself without any need for treatment but if it doesn’t then it will need to be repaired by myringoplasty.

The surgeon will take a small section of skin from near the ear to graft over the ear drum. This is ‘glued’ in place until it begins to take.


This procedure is carried out in the case of persistent ear infections such as glue ear. With glue ear, a viscous fluid builds up in the space behind the ear drum which affects air pressure in that space, causing the ear drum to tighten. The surgeon will make a tiny incision in the ear drum to relieve the tension caused by this air pressure. He/she will then clear out this fluid and allow the remainder to drain away from the ear.

Once this has been done he/she will insert a small tube called a grommet into the ear drum which keeps the incision open and prevents the risk of a further infection. This incision will close up once the grommet falls out.


The stapes are one of the three tiny bones in the middle ear known as the ossicles.

But if this grows abnormally then it can prevent the normal passage of sound waves through the ear resulting in hearing loss.

A stapedectomy involves the removal of most of or all of the stapes and replacing this with a prosthetic.


This is surgery to reconstruct a perforated ear drum which is caused by chronic ear infections such as otitis media or has failed to heal properly. This perforated ear drum can cause conductive hearing loss.

The ear drum is lifted forward from the ear canal. A piece of tissue is removed from the ear and grafted over the ear drum to cover the site of the perforation. The ear drum is then placed in its original position.

In some cases the ossicles need to be reconstructed and this can be performed before work is carried out on the ear drum.


This is nothing to do with the well known animation by Nick Park but refers to the small tubes, used by surgeons to treat chronic ear infections such as glue ear.

What is a ‘grommet?’

A grommet is a small tube, usually made from Teflon which is inserted into the ear drum to help relieve pressure upon it.

Why are they used?

They are mainly used to treat persistent or chronic middle ear infections such as otitis media and glue ear. Glue ear usually develops in children although adults can suffer from this as well. It occurs as a result of a build up of fluid in the middle ear which develops an infection causing it to become a thick, sticky substance.

This substance increases air pressure within the middle ear which prevents the ear drum from functioning as normal which results in hearing loss.

If your child is prone to chronic ear infections on a regular basis then your GP may refer you to an ear specialist. He or she will discuss the possibility of having grommets inserted which will help reduce pressures on the ear drum and enable the infected fluid to drain away from the middle ear.

This procedure is performed under a general anaesthetic and the results are almost instantaneous.

What your child may find is that they have become so used to impaired hearing as a result of these infections that it takes a bit of time to get used to their ‘clear as a bell’ hearing.

There are very few risks with grommets, the main one being that of the grommet falling out of the ear drum but a new pair can be re-inserted.

The ear specialist will discuss the risks as well as the benefits of this procedure beforehand.


You will be given a set of guidelines on how to care for your grommets.

These include:

  • Avoid water getting into your ear. Wear a swimming cap or use ear plugs. This applies when swimming, bathing or in the sea.
  • Avoid diving in when swimming.
  • Dry the ears thoroughly after submersion in water.

If you are concerned about the effect of flying on your ears (or those of your child) then don’t be as having grommets can be an advantage. Many of us have experienced painful or blocked ears when flying which is due to the change in air pressure within the plane.

But grommets help to equalise air pressure within your ears so this shouldn’t be a problem. Grommets fall out of the ears after surgery, anywhere between six months and two years. This is completely normal and doesn’t usually cause any problems. The ear drum will have healed and hopefully, you (or your child) won’t experience any more ear infections.

Treatments : A guide to Hearing Loss

Hearing Loss

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