A Perforated Eardrum Needs Surgery? An ENT Specialist Explains

Problems with the eardrum are one of the leading causes of conductive hearing loss. In many medical cases, a perforated eardrum requires serious treatment through surgical intervention to prevent permanent hearing loss. Dr Harim Priyono, a Specialist in THT-BKL (Ear, Nose, Throat - Head and Neck Surgery), states that repairing the eardrum is crucial because the hole becomes a gateway for recurrent infections and disrupts ear health. According to Dr Harim, the primary principle of managing a perforated eardrum is via surgery. This is based on the differences in the environment between the outer ear and the area behind the eardrum. ‘If there is a hole in the eardrum, the principle is to operate. Because the environment in the external ear canal differs from the environment behind the eardrum,’ he explained during an online discussion organised by RSUP Nasional Dr. Cipto Mangunkusumo. Anatomically, the ear canal connects directly to the external environment, whereas the cavity behind the eardrum is connected to the airways via the tuba eustachius (Eustachian tube). This difference makes the microorganisms in the two areas different. If the barrier (the eardrum) is damaged, the risk of infection increases sharply because the two areas are connected. The standard medical action to close a hole on a perforated eardrum is called tympanoplasty. This procedure aims to reconstruct tissue so that the ear’s structure is restored. Although surgery aims to restore anatomy so that the ear is healthy again, Dr Harim reminds that the recovery of hearing function heavily depends on the extent of the initial damage. In some cases where the damage to the hearing bones is already quite severe before surgery, hearing may not return to 100 percent normal. If this occurs, doctors will recommend further rehabilitation steps, such as: For the public experiencing symptoms of a frequently draining ear or reduced hearing, it is highly advised to consult with an ENT doctor promptly to obtain an accurate diagnosis before damage to the eardrum and hearing loss become more extensive. Conductive hearing loss can affect children to adults. Recognise causes such as cerumen and the Eustachian tube and how to manage them from an ENT doctor. ENT doctors note that a perforated eardrum can be caused by trauma or infection, which can disrupt hearing.