Tympanoplasty type 1, alternatively called myringoplasty, is the reconstruction of the perforated tympanic membrane using a material such as temporalis fascia.

Perforation of the tympanic membrane.

Following dissection of the soft tissues, and exposure of the external auditory canal and mastoid, the temporal bone is ready for the procedure. Care has been taken to preserve the tympanic membrane and the skin of the external auditory canal.

EAC: External auditory canal

MT: Mastoid tip

TL: Temporal line

ZR: Zygomatic root

Using a curved micro knife, an incision is made in the skin of the posterior wall of the external auditory canal, at a distance of 3–4mm from the annulus fibrosis, parallel to it.

II: Curved micro knife

MIL: Annulus fibrosis

AF: Annulus fibrosis

HS: Henle spine

TM: Tympanic membrane

Next, a second incision is made superiorly using a No.11 blade or sickle knife. This incision should begin just anterior to the short process of malleus medially, and join the superior edge of the first incision laterally.

II: No.11 blade or sickle knife

MIL: Short process of malleus