Tympanoplasty and Mastoidectomy Surgeries

Surgery is performed under general anesthesia in most cases.  Indications for surgery include tympanic membrane perforation, infection, Chronic Otitis Media, Cholesteatoma, and others.  There are many variations to these procedures that are commonly used for treating chronic ear infections.  In the majority of circumstances the patient will be performed on an outpatient basis.  Occasionally, these surgeries will be used to approach different areas of the ear and skull base to treat other conditions.


Repairs of holes in the ear drum and removal of cholesteatoma from the middle ear requires a tympanoplasty procedure.  A perforation is  commonly repaired with cartilage from the ear or lining from nearby muscle.  This surgery can be performed through the ear canal or through an incision behind the ear depending on the specific details of each case.  This is an outpatient procedure.

Tympanoplasty with Ossiculoplasty

This is the operation performed to repair both the sound transmitting mechanism and any perforation of the eardrum, while removing any disease in the middle ear.  Cholesteatomas may damage one or all three of the bones in the middle ear that transmit sound from the eardrum to the inner ear.  The ossicles are repaired with the use of a small artificial prostheses.  In some instances this requires a “staged procedure” (i.e. the tympanoplasty is performed first and 6-12 months later the ossiculoplasty is completed).  This is an outpatient procedure.

Tympanoplasty with Mastoidectomy Procedures

When chronic ear infections, cholesteatoma, and other ear conditions involve the mastoid cavity and an additional mastoid procedure is required.  The mastoid is a honeycombed, air filled bone behind the ear that connects to the middle ear space.  There are a variety of different versions of mastoid surgery:

  • Tympanoplasty with Mastoidectomy

  • Canal wall up Mastoidectomy

  • Canal wall down Mastoidectomy

  • Canal wall down with mastoid obliteration

  • Modified Radical Mastoidectomy

  • Radical Mastoidectomy


Many times findings at the time of surgery will dictate the specific procedure that needs to be performed in order to most effectively treat disease.  A mastoidectomy is performed via an incision behind the back of the ear.  Occasionally mastoid surgery is performed to access other areas of the inner ear and skull base.  Most often it is an outpatient procedure.

Patient Comments

“I have been almost def in my left ear for over 30 years. When I was referred to Iowa Ear for a consult I wasn’t completely sure what the outcome would be. I had a tympanoplasty three months ago and my hearing was restored. I am so greatful for Dr. Carfrae, because he gave me back something that I thought I would never have!”