Surgery to repair a large hole in the eardrum
(known as tympanic membrane perforation) can be accomplished through the ear canal. In this underlay technique, the skin of the
ear canal along with the perforated eardrum is first lifted off
the bone. A graft is than placed in such a way that
it lays under the eardrum after the skin is placed back down into normal position. Cartilage is often placed to provide support
to the graft. Dissolvable gelfoam sponges are placed to
help keep everything together as it heals. Please note that in reality, the skin flap
is elevated off the back side of the ear canal and not from the bottom as shown in this animation.