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    Myringoplasty tips
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    my2cents posted:
    I had a perforated eardum resulting from trying to irrigate my ear with a water-filled rubber bulb to remove ear wax after prepping a few minutes with hydrogen peroxide to create bubbles under the wax. Don't try it, especially if you are getting old, because your skin gets thinner, and your eardrum may perforate, particularly if you don't leave enough egress room for the water. Go to an ENT doctor with a lighted microscope to get ear wax removed if you leave it too long and it gets impacted.

    The size of the hole was about 4 mm, and it didn't heal spontaneously even after seven months. The doctor extracted wax at that point using a lighted microscope, and there was a little piece of skin under the wax. He "freshened" (gently removed mature scar tissue from) the majority of the borders of the hole without anesthetic, with negligible pain. He stopped when it started to hurt. He put the piece of skin over the hole. This only took a few minutes. Four months later when I went back, he reported complete closure of the hole. However, the part of the eardrum over the hole was a thin, single layer of skin rather than the multiple layers in the original intact drum. He was not sure whether the new skin would thicken later. He advised against doing anything that put a lot of barometric pressure on the drum. I will go back to him again in another six months or so to see if the skin has thickened. Meanwhile, I can swim without a waterproof ear band, and that is good news. I don't know whether a fat plug or other type of myringoplasty would have been a better idea for a thicker growth (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2691897/ ). I had not known about this article when I went to the office, and am not sure whether the gelfoam used in the middle ear dissolves later. Apparently this approach can also be done in the office under local anesthesia, if I understand correctly, and that is likely what I will try if my perforation opens again. Something to keep in mind is that the code for the procedure the doctor used on me is for myringoplasty, which is a general term. The retail cost was well over $2,000, with Medicare and insurance covering it at a vastly lower rate. So if you're going to get this skin patch thing done at retail, it might be a good idea to talk to the doctor first about the price. It took about 15 minutes of his time. Best of luck to all you swimmers and surfers and others out there who have eardrum damage. See you at the beach.
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