Repair of an Eardrum Perforation

#1:  The ear canal is injected with 1% Xylocaine with Epinephrine for anesthesia and hemostatsis (to reduce bleeding).
#2:  The skin lining the edges of the eardrum perforation is removed.
#3:  The eardrum and ear canal skin are reflected forward.
#4:  Fascial Graft (tendon) is placed under eardrum.
#5:  Gelfoam is placed in the middle ear and under graft to hold it in place.
#6:  The eardrum, ear canal skin and graft are placed back in position and secured with gelfoam and packing in the ear canal.