Before the timeline
This page follows the weeks after tympanoplasty, the operation that repairs a hole in the eardrum (see eardrum perforation). General advice for any ear operation is on recovery after ear surgery; this page covers what is specific to eardrum repair.
Timings vary between surgeons, and none has been tested in trials. The ranges below are typical, not rules, and differ from those after stapes surgery (stapedotomy recovery). If the ossicles were rebuilt at the same time (ossiculoplasty) or the mastoid was opened (mastoidectomy), the pattern is similar but recovery can take longer. Where your surgeon’s instructions differ, follow theirs.
Why the first weeks are cautious
The graft, usually fascia from above the ear or cartilage from the ear itself, is a scaffold. The edges of the old eardrum grow across it over the following weeks, and it becomes part of a new, slightly thicker eardrum. At first it is held in place only by dissolvable packing.
Two things threaten it in this phase: a surge of pressure from the nose (forceful nose-blowing, sneezing with the mouth closed, straining), which can lift the graft, and water or infection reaching the healing drum. Almost every early restriction exists to prevent one of these.
Day of surgery
The repair is done through the ear canal, with a microscope or an endoscope, or through a small incision behind or in front of the ear. Most operations are under general anaesthesia; some surgeons repair suitable perforations under local anaesthesia, with similar closure rates in a pooled analysis. Many patients go home the same day or after one night; practice varies between centres.
Normal: packing in the ear canal with cotton wool at the opening; a blocked, muffled ear; a dressing or head bandage if there was an incision; mild pain.
Avoid: driving (arrange to be taken home), bending, lifting and nose-blowing.
The first days
Normal: a blocked ear with popping and crackling; a little blood-stained discharge on the cotton wool; mild pain that paracetamol controls; a numb or tender area around an incision; a metallic or altered taste on one side of the tongue. Dizziness is usually slight or absent, because the inner ear is not opened, although brief unsteadiness on sudden movement can occur.
Avoid: nose-blowing (sneeze with your mouth open), straining (a mild laxative can help), heavy lifting, and water in the ear. Change the cotton wool when it is soiled, put nothing else in the ear, and use any drops exactly as prescribed.
Week 1
Most people feel themselves again within a week or two. Hearing is still muffled, often worse than before the operation; this says nothing about the result. Stitches from an incision are removed after about a week, or dissolve.
Taste change is common after middle-ear surgery and usually temporary. In a prospective study of 140 middle-ear operations, 15% of patients noticed a change in taste, and three-quarters of them had recovered within a year.
Gentle walking is fine. Keep avoiding nose-blowing, lifting, strenuous exercise, swimming and flying.
Weeks 2–3
The packing is removed at the first visit, often at one to three weeks, or dissolves; some surgeons prescribe drops to soften it. As the canal clears, many people notice the ear opening up, although the middle ear may still hold some fluid.
Desk work is usually possible now. Keep the ear completely dry, and keep avoiding forceful nose-blowing, heavy lifting, strenuous exercise and contact sport.
Weeks 4–6
The graft is usually checked at around six weeks. It can look white or thick at this stage; what matters is that it is closed and the ear is dry. If your surgeon is satisfied, most restrictions are lifted: flying, the gym and swimming. Contact sport, heading a ball and martial arts may wait a little longer. If a gap remains, your surgeon will advise whether to watch it or plan a further repair; a second operation is sometimes needed.
Months 2–3
The new eardrum settles, the middle ear fills with air, and hearing continues to improve. A changed taste has usually recovered or is recovering.
The audiogram and graft check
The result is measured at three months or later, sometimes with a further test at six months to a year. As on the tympanoplasty page, two questions are answered separately. Is the eardrum closed and the ear dry? And how has hearing changed? The hearing test shows how far the air-bone gap has closed and confirms that inner-ear (bone-conduction) hearing is unchanged.
For a first repair of a chronic perforation, the eardrum is closed at one year in roughly 85–95% of ears; a pooled analysis of over 26,000 patients found 86.6%. Closure is more likely with smaller perforations and with cartilage grafts, and slightly less likely in children.
Hearing gain depends mainly on the ossicles and the middle-ear lining, not on the graft, and is often 10–20 dB when the ossicles are intact. A re-perforation can occur early from infection or later from poor ventilation; see chronic middle-ear disease. A disappointing or fading result is approached as described under revision ear surgery.
Returning to work
- Desk or home-based work: often after one to two weeks, sooner from home if you feel well.
- Physical work and heavy lifting: often two to four weeks, sometimes longer.
- Work that depends on hearing (telephone, teaching): plan around a blocked ear for the first weeks.
- Noisy, dusty or wet workplaces: when your surgeon agrees, with the ear protected and dry.
- Pilots, cabin crew and divers: discuss specifically with your surgeon.
Swimming and water
Until your surgeon has confirmed that the eardrum is closed, keep water out completely: a cotton-wool ball smeared with petroleum jelly for showering, hair washed with the head tilted away, no swimming and no head under water in the bath.
Once the drum is confirmed closed, often at the six-week check, most surgeons allow swimming on the surface. Jumping or diving in and swimming underwater usually wait longer. Scuba diving involves far larger pressure changes than flying; a period of months and a check of how the ear equalises pressure are usual first.
Flying
Most surgeons advise waiting about four to six weeks, until the graft is confirmed to have taken and the middle ear is aerated. Ask before booking. Avoid flying with a cold, and equalise gently on descent only once your surgeon has said you may. See flying after ear surgery.
Warning signs that need same-day review
Seek care the same day for:
- Facial weakness on the operated side. Weakness in the first hours can come from the local anaesthetic and wear off; weakness that appears later, or does not resolve, needs assessment without delay.
- Severe or spinning vertigo with vomiting, or a sudden drop or complete loss of hearing in the operated ear. This is uncommon after tympanoplasty, and early assessment matters.
- Severe headache, neck stiffness, high fever, drowsiness or confusion.
- Heavy bleeding that does not stop with gentle pressure, or swelling behind the ear with pain and redness.
Call within a day or two for discharge that increases or becomes thick, yellow or smelly, pain that increases after settling, fever, hearing that slips back gradually over several days after it had begun to improve, dizziness beyond the first days or set off by loud sound or pressure, or loud new tinnitus. If you cannot reach your surgeon, go to an emergency department and say what operation you had and when. Later on, contact your clinic if discharge returns or hearing that had improved declines. The full list is on when to contact your surgeon.
Evidence behind the timings and the take rates
Restrictions after tympanoplasty rest on physiology and caution rather than trials. A meta-analysis of 214 studies (26,097 patients, primary non-cholesteatomatous type I) found 86.6% closure at 12 months, 5.8% higher failure in children, 6.1% better closure for perforations under 50% of the drum and 2.8% better with cartilage than fascia. A meta-analysis of 18 RCTs favoured cartilage for take at 12 and 24 months (OR 2.24 and 2.96) with no difference in air-bone gap closure. Endoscopic and microscopic tympanoplasty had comparable graft failure and air-bone gap results across 33 studies, with less wound infection, dysgeusia and auricular numbness than the postauricular microscopic route. Closure after local and general anaesthetic myringoplasty (87% and 91%) did not differ significantly.
Sources
- Tan HE, Santa Maria PL, Eikelboom RH, et al. Type I tympanoplasty meta-analysis: a single variable analysis. Otol Neurotol. 2016;37(7):838-46. PubMed
- Lajdam GB, Alahmadi RA, Alhakami M, et al. Comparison of temporalis muscle fascia and cartilage grafts for primary type 1 tympanoplasty: a meta-analysis of randomized controlled trials. Eur Arch Otorhinolaryngol. 2023;280(12):5153-5165. PubMed
- Gkrinia E, Ntziovara AM, Brotis AG, et al. Endoscopic versus microscopic tympanoplasty: a systematic review and metanalysis. Laryngoscope. 2024;134(8):3466-3476. PubMed
- Kaleva AI, Raithatha A, Tomasoni M, et al. General anaesthetic vs local anaesthetic myringoplasties: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2023;280(5):2237-2245. PubMed
- Michael P, Raut V. Chorda tympani injury: operative findings and postoperative symptoms. Otolaryngol Head Neck Surg. 2007;136(6):978-81. PubMed
Common questions
How long is the recovery after tympanoplasty?
Most people feel themselves again within one to two weeks and can return to desk work in that time. The ear takes longer: packing and a blocked feeling last one to three weeks, the graft is usually checked at around six weeks, and hearing is judged at three months or later. Flying, swimming and strenuous exercise wait until your surgeon is satisfied with healing. Timings vary between surgeons, so follow the advice given for your own operation.
When will my hearing improve after tympanoplasty?
Not straight away. While packing, blood and swelling fill the ear canal and middle ear, hearing is usually worse than before the operation. It improves as the packing clears over the following weeks, and keeps changing for several months as the new eardrum settles and the middle ear fills with air. The result is measured on a hearing test at three months or later. How much it improves depends mainly on the ossicles and the middle-ear lining.
When can I fly after tympanoplasty?
Most surgeons advise waiting about four to six weeks, until the graft has been seen to take and the middle ear is aerated. Ask before booking, avoid flying with a cold, and do not force air into the ear unless your surgeon has said you may.
Can I swim after tympanoplasty?
Not until your surgeon has seen that the eardrum is closed, commonly at the check around six weeks and sometimes later. Until then keep water out of the ear completely: a cotton-wool ball smeared with petroleum jelly for showering, and hair washed with the head tilted away. Jumping or diving into water and swimming underwater usually wait longer. Scuba diving needs a specific discussion and often a check of how well the ear equalises pressure.
When can I go back to work after tympanoplasty?
Desk or home-based work is often possible after one to two weeks, sooner if you feel well. Physical work and heavy lifting usually wait two to four weeks, sometimes longer, because straining raises pressure in the ear. Noisy, dusty or wet workplaces, and jobs that depend on hearing in the operated ear, may need longer. Pilots, cabin crew and divers should discuss their work specifically with their surgeon.
What is the success rate of tympanoplasty?
For a first repair of a chronic perforation, the eardrum is closed at one year in roughly 85–95% of ears; a pooled analysis of over 26,000 patients found about 87%. Closure is somewhat more likely with cartilage grafts and smaller perforations, and slightly less likely in children. A closed eardrum is not the same as better hearing: the gain depends mainly on the ossicles and the middle ear, and is often 10–20 dB when the ossicles are intact.
This page provides general educational information. It cannot replace an individual assessment, which depends on a full history, examination, audiometry and, where relevant, imaging. If you have sudden hearing loss, severe pain, facial weakness, severe dizziness or discharge with fever, seek medical care promptly.