The surgical procedure for placing tubes in the ears has become one of the most commonly performed operations of any kind.  A tiny tube, with a collar on both ends is slipped through a tiny incision in the eardrum. This pressure-equalization (PE) tube provides a temporary, extra Eustachian tube to allow bacteria and fluid to drain from the middle ear. 

Tympanoplasty

The tympanic membrane, or ear drum, is made of tissue similar to skin. In most cases, perforations of the ear drum by some type of trauma, such as a puncture by a cotton tipped applicator, or a slap injury, will heal spontaneously, in much the same way a cut on an arm would heal.

When a tympanic membrane perforation persists, the middle ear is unprotected and is vulnerable to infection. When a perforation is present, the ear canal must be kept dry. Repair of the tympanic membrane perforation reinstates the protective barrier to the middle ear, and in some cases can also improve hearing.

Mastoidectomy

Mastoid air cells are open, air-containing spaces in the skull behind the ear. A mastoidectomy is the surgical removal of these mastoid air cells. The surgery may extend into the middle ear.

The surgery used to be a common way to treat an infection in the mastoid air cells, which usually came from an ear infection that spread to the nearby bone in the skull. Mastoidectomy is now seldom needed, as the infections are commonly treated with antibiotics. However, this surgery may be used to treat other problems.

Ossicular Reconstruction

Ossicular reconstruction is the reconstruction of tiny bones of the middle ear.  If the gap between the anvil bone and the stapes is small, a small piece of bone or cartilage from the patient can be inserted; if is is large, the incus bone is removed, modelled into a prosthesis, and reinserted between the stapes and the malleus. Reconstruction could also be achieved by inserting a strut made from artificial bone. For tympanoplasty with ossicular reconstruction, the patient usually stays in the hospital overnight. The recovery period is about four weeks.

Stapedectomy

Patients with otosclerosis and significant hearing loss are candidates for a stapedectomy.  During a stapedectomy, an incision is made in the skin of the ear canal, the skin and eardrum are lifted to expose the stapes bone, and the stapes bone is removed. An incision is made above the ear and the tissue is removed. The tissue is used to cover the opening created by the stapes bone removal. A prosthesis is put in place where the stapes bone had been and the eardrum and skin of the ear canal are laid back in place. The ear canal is then packed.