Ear Surgery
Micro ear surgery for hearing loss, a persistently discharging ear, vertigo and facial weakness — using the operating microscope and, where suitable, LASER.
The ear is unforgiving of imprecision. Hearing depends on a chain of three bones, each smaller than a grain of rice, working against an eardrum a tenth of a millimetre thick — which is why ear surgery is done under an operating microscope rather than by eye. Dr. Satish Babu has performed micro ear surgery for 27 years, covering the full range from eardrum repair and ossicular reconstruction through to stapes surgery for otosclerosis, along with the management of vertigo and facial nerve problems. Many ear complaints, however, do not need an operation at all, and the first job of a consultation is to establish which situation you are actually in.
Micro ear surgery is any ear operation performed under high magnification using an operating microscope, allowing work on structures measured in fractions of a millimetre. Tympanoplasty repairs a perforated eardrum, usually using a graft of the patient's own tissue, and can restore both hearing and a dry, infection-free ear. Ossiculoplasty reconstructs the small bones that carry sound to the inner ear when disease or infection has eroded them. Stapedotomy treats otosclerosis, a condition where the stapes bone becomes fixed and stops transmitting sound, by creating a precise opening and placing a tiny prosthesis. Mastoid surgery removes chronic infection or cholesteatoma from the bone behind the ear. Each is a different operation for a different problem — which is why an accurate diagnosis, supported by audiometry and imaging where needed, matters more than the choice of technique.
See a specialist if
Diagnosed and managed here
What is involved
Microsurgical repair of a perforated eardrum using the patient's own tissue as a graft, to stop recurrent discharge and improve hearing. Where suitable, LASER-assisted technique allows more precise work with less trauma to surrounding structures.
Reconstruction of the middle ear bones when infection or disease has eroded the sound-conducting chain, restoring the mechanical pathway between eardrum and inner ear.
LASER-assisted stapes surgery for otosclerosis, where a fixed stapes bone is bypassed with a small prosthesis. A technically demanding procedure that can produce a substantial improvement in conductive hearing loss.
Removal of chronic infection or cholesteatoma from the mastoid bone, undertaken to make the ear safe and prevent complications, with hearing reconstruction where the disease allows.
A short day procedure for persistent middle ear fluid, most often in children with glue ear that has not settled with medical treatment and observation.
Structured evaluation to distinguish inner ear causes of vertigo from other origins, followed by appropriate treatment — which for many causes, including BPPV, is positional manoeuvres and medication rather than surgery.
Before You Agree to an Operation
A large proportion of ear complaints seen in clinic are managed without an operation. These are situations where a conservative approach is commonly appropriate — though only an examination, and usually a hearing test, can establish what applies in your case.
It depends entirely on the cause. Where hearing loss is conductive — a perforated eardrum, an eroded ossicular chain, or a fixed stapes — surgery addresses a mechanical problem and can improve hearing meaningfully. Where the loss is sensorineural, arising from the inner ear or hearing nerve, surgery does not correct it and a hearing aid is the appropriate route. An audiogram distinguishes the two, which is why a hearing test is done before any surgical discussion.
Not immediately. Many perforations heal spontaneously, so an initial period of observation is usual. Repair is considered when a perforation has persisted, when the ear discharges repeatedly, or when hearing is affected enough to matter. The ear also needs to be dry and free of active infection before grafting, as operating on an infected ear risks graft failure.
Most micro ear procedures are performed under general anaesthesia, though some — including certain stapes operations — can be done under local anaesthesia with sedation. The choice depends on the procedure, your general health, and anaesthetic assessment, and is discussed with you before surgery.
Most patients go home the same day or the following day. The ear is typically packed for one to two weeks, and hearing often sounds muffled until the packing is removed and swelling settles. You will be advised to keep the ear dry, avoid nose-blowing and air travel for a defined period, and attend follow-up so healing and hearing can be checked.
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