Based on ENT-UK website.
A perforated eardrum means there is a hole in the eardrum, which may have been caused by infection or injury. Quite often a hole in the eardrum may heal itself. Sometimes it does not cause any problems. However it may cause recurrent infections with a discharge from the ear. If you have an infection you should avoid getting water in the ear. If the hole is large then you may experience some hearing loss.
An operation to repair the perforation is called a ‘myringoplasty’. The benefits of closing a perforation include prevention of water entering the middle ear, which could cause ear infection. Repairing the hole means that you should get fewer ear infections. It may result in improved hearing, but repairing the eardrum alone seldom leads to great improvement in hearing.
If the hole in the eardrum has only just occurred, no treatment may be required. You should discuss with Mr. Chisholm whether to wait and see, or have surgery now.
The operation is almost always done under general anaesthetic. A cut is made behind the ear or above the ear opening. Occasionally, Mr Chisholm may need to widen the ear canal with a drill to get to the perforation. The material used to patch the eardrum is taken from under the skin. This eardrum ‘graft’ is placed against the eardrum. Dressings are placed in the ear canal. You may have an external dressing and a head bandage for a few hours. The operation can successfully close a small hole nine times out of ten. The success rate is not quite so good if the hole is large.
A cholesteatoma is a cyst or sac of skin that is growing backwards behind your eardrum into the middle ear and mastoid. It results in a chronic, smelly discharge, and the longer it remains the more damage it can do to the delicate structures of the ear.
If left untreated, after many years it could destroy your hearing, destroy your balance organ and damage your facial nerve which would give you a paralysed side of your face. It can also cause brain infections, because the ear is so close to the brain. It is therefore necessary to remove it, before it is able to cause such damage.
By removing the cholesteatoma, you should no longer be at risk of these complications. It may also be possible to improve your hearing in that ear.