Article written by Dr Ameen, ENT Specialist Kuala Lumpur
Myringoplasty is a surgical procedure to repair a perforated eardrum. I perform this operation to close the hole in the tympanic membrane using a small tissue graft. The surgery takes about one and a half to two and a half hours. I usually harvest a thin layer of fascia from the temporalis muscle or perichondrium from the tragus. The graft is placed over the perforation to stimulate healing. You will wake up with packing material inside the ear canal. Mild dizziness and a feeling of fullness are normal for the first few days. Most patients in my Kuala Lumpur practice undergo this as a day surgery or stay for just one night for observation.
Indications for Myringoplasty
- Chronic tympanic membrane perforation: A persistent hole in the eardrum that fails to heal on its own after several months.
- Recurrent acute otitis media: Frequent ear infections that cause pain and discharge due to water entering the middle ear through the perforation.
- Conductive hearing loss: Reduced hearing ability caused by the inability of the damaged eardrum to vibrate properly and transmit sound waves.
- Need for unrestricted water exposure: Patients who wish to swim or shower without the strict need for ear plugs to prevent infection.
Complications of the Surgery
- Graft failure or reperforation: 10 to 15 percent. The tissue graft may not take completely, requiring a secondary repair procedure.
- Temporary taste disturbance: 5 to 10 percent. The chorda tympani nerve runs across the eardrum and can be stretched, causing a metallic taste or numbness on the tongue.
- Temporary dizziness or vertigo: 5 to 8 percent. Manipulation of the middle ear structures can cause mild balance issues that resolve within a few days.
- Tinnitus: 2 to 5 percent. Ringing in the ear may occur temporarily due to surgical manipulation or changes in middle ear pressure.
- Worsening hearing loss or deafness: Less than 1 percent. Damage to the inner ear structures is extremely rare but can cause permanent sensorineural hearing loss.
- Facial nerve weakness: Less than 0.1 percent. Injury to the facial nerve running through the middle ear is exceedingly rare in standard myringoplasty.
Estimated Procedure Cost (Professional Fees)
Medical fees in Malaysia are guided by the Private Healthcare Facilities and Services Act. Based on the PHFSA 2013 regulations for myringoplasty (Code D1420), the maximum allowable professional fees are:
- Surgeon Professional Fee (MAJOR 4): RM2,040
- Anaesthetist Professional Fee (MAJOR 4): RM760
- Total Maximum Professional Fees: RM2,800
Total Estimated Cost
- Total Estimated Cost (including hospital facility fees, operating theatre charges, specialised equipment rental, medications and consumables): RM15,000 to RM17,000
- Disclaimer: This is an estimated total cost only. Actual bills vary significantly depending on the specific hospital, room type and individual patient needs across Malaysia. Patients should always request a detailed itemised cost estimate from their chosen hospital or medical centre before proceeding.
Frequently Asked Questions
Will I hear better immediately after the surgery? Your hearing will initially be muffled due to the packing material inside the ear canal. Once the packing is removed and the ear heals over a few weeks, you will notice a significant improvement in sound transmission.
Can I fly or swim after a myringoplasty? You must avoid flying and swimming for at least three to four weeks to allow the graft to heal completely and to prevent pressure changes or water infection from displacing the tissue patch.
What material is used to patch the eardrum? I typically use a very thin layer of your own tissue, such as temporalis fascia from the muscle above your ear or perichondrium from the tragus cartilage, to ensure the best biological compatibility and healing.
Is the surgery painful? The procedure itself is painless due to general anaesthesia. Post operatively, you may experience mild to moderate earache and a feeling of fullness, which is easily managed with standard oral painkillers.
Will the hearing improvement be permanent? If the graft heals successfully and the underlying middle ear bones are healthy, the hearing improvement is generally permanent. However, future ear infections or trauma can potentially cause a new perforation.
When to Seek Consultation
Living with a perforated eardrum means constantly worrying about water exposure and dealing with recurrent, painful ear infections. It also affects your daily communication and overall quality of life. Modern microsurgical techniques offer a highly successful way to restore the integrity of your eardrum and improve your hearing.
If you have a known eardrum perforation or suffer from repeated ear discharge, do not wait until the infection causes deeper damage. Book a consultation at my Kuala Lumpur clinic for a thorough microscopic examination and audiogram. We will map out a clear, personalized treatment plan to restore your ear health.
About the Author
Dr. Ameen is a Resident Ear, Nose & Throat Consultant at KPJ Ampang Puteri Specialist Hospital, situated in Selangor near the Kuala Lumpur border and serving patients from both Ampang and Kuala Lumpur.
He earned his medical degree (MB BCh BAO Hons) in Ireland and completed his Master of Otorhinolaryngology at Universiti Kebangsaan Malaysia. With comprehensive tertiary training from Hospital Kuala Lumpur and Hospital Tunku Azizah, he expertly manages complex adult and pediatric ENT conditions, including sinus, ear, throat, and vertigo disorders.
Before taking on his current role as a Resident ENT Consultant at KPJ Ampang Puteri Specialist Hospital, Dr. Ameen spent three years building extensive private center experience in Kuala Lumpur as a sessional ENT Consultant at Sunway Medical Centre Velocity and Columbia Asia Hospital Setapak.
