Consent: Myringoplasty

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Last updated: October 26, 2022
Revisions: 6

Last updated: October 26, 2022
Revisions: 6

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This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines, and the applicable and appropriate law in your jurisdiction governing patient consent.

Overview of Procedure

Myringoplasty is a procedure performed to repair a tympanic membrane perforation, performed under general anaesthesia.

A graft of fascia, cartilage, or perichondrium is taken to repair the defect in the tympanic membrane, typically harvested from the temporalis fascia or tragus cartilage.

The primary intended benefit of myringoplasty is to prevent recurrent middle ear infection, with a secondary benefit of potential improved hearing.

Figure 1 – Illustration of a Myringoplasty

Complications

Intra-Operative

Complication Description of Complication Potential Ways to Reduce Risk
Bleeding A rare complication from this type of surgery, however may occur in anatomical variations of the position of the sigmoid sinus If the patient has a high-resolution CT pre-operatively, the position of the sigmoid sinus should be carefully inspected
Anaesthetic risk Includes damage to the teeth or larynx from intubation, adverse reaction to drugs, nausea and vomiting, cardiovascular and respiratory complications. Part of the anaesthetic assessment before an operation.

 

Early

Complication Description of Complication Potential Ways to Reduce Risk
Pain Most people will experience discomfort after the operation Ensure patient is prescribed regular simple analgesia post-operatively
Infection Whilst infection of the graft site, donor site, or middle ear cavity is possible, this is uncommon
Bleeding Any packs in situ should not be removed until the first clinic follow up (even in the context of bleeding post-operatively)
Allergic reaction to packing material  The packing used (BIPP packing) may cause a localised reaction, resulting in the pinna and soft tissues becoming hot and erythematous within 24-36 hours Alternative dressings should be used if patient is known to be hypersensitive
Tinnitus or dizziness This is usually transient

 

Late

Complication Description of Complication Potential Ways to Reduce Risk
Graft failure A small proportion of patients will have graft failure, whereby the graft does not take on the eardrum Encourage smoking cessation peri-operatively
Hearing loss Whilst uncommon, this can occur if the ossicular chain is disrupted intra-operatively
Facial paralysis Caused by damage to the facial nerve; can be complete or partial, however fortunately is very rare
Taste disturbance Caused by damage of the chorda tympani, as this runs across the superior tympanic membrane; most cases improve with time, however rarely can be permanent