Will tympanoplasty improve low hearing?

Q: I am a 37 years old female has been diagnosed with right ear drum perforation 20 years back, which has not healed till now. A few years back, I was diagnosed with left ear perforation also. Around five months back, I had a severe cold and went to a doctor who told me that there is no perforation in left ear but rather the ear cover is thrown back. But often when I have cold I experience temporary less hearing in right ear or some strange noises but after sometime it resolves on its own. I also suffer from vertigo. Yesterday I used an ear bud to clean wax from my right ear and since morning I am experiencing less hearing in right ear and echo sounds and strange noises again. I went to the doctor who said that there is inflammation in the ear and infection. He prescribed Droxyl (500mg) for 5 days. He has also given ear drop Betnesol-N. But I am quite apprehensive about taking Betnosol-N ear drops as it contains neomycin and it’s clearly written on the medicine box also that not to be taken if there is perforation of tympanic membrane. I also read many times that when there is ear perforation no ear drops should be recommended as it enters the middle ear and inner ear and causes ototoxicity. Am I on right treatment? Is vertigo linked with my ear problem? Is tympanoplasty 100 percent successful or it can make hearing worse at times?

A:I have gone through your history. Detailed advice is only possible after seeing the ear drums (otoscopy), and the audiometry report.

You can safely take ear drops. If there is a perforation, ear drops is the only way to make the antibiotic reach the middle ear. Betnesol is steroid and will reduce inflammation. The risk of ototoxicity with neosporin is negligible. It is fairly safe. Gentamicin must be avoided. In case you have apprehensions, you could use chloramphenicol, or ofloxacin, or norfloxacin ear drops.

Yes, the vertigo can be related with ear infection / perforation.

Tympanoplasty: There is no surgery / surgeon in the world who can guarantee 100% success rates. The success rates after Tympanoplasty are about 90-95%. In the rest, for some reason the body rejects the graft or there is infection, and the residual perforation remains. Hearing improvement also depends on the status of the ossicles: small bones in the middle ear which conduct the sound. Risk of hearing going down (total SN loss) are negligible, maybe 1 in 10,000, or even less. Definitely far less than you being involved in a road traffic accident while driving a vehicle.