Granular myringitis is a problem that we all encounter. There is no good definition for granular myringitis in post-surgical ears but the term is loosely applied to ears where there is a small area of granulation tissue on the grafted tympanic membrane or in the mastoid cavity.

It may appear many months after surgery in what was initially a well healed ear, and there are usually no obvious identifiable causes. There are several papers about granular myringitis in patients with no history of ear surgery but none about post-surgical patients. It is rarely mentioned in case series, but all surgeons encounter it.

There is no good evidence on aetiology or on treatment, in post-surgical cases or in non-surgical cases. Many treatment modalities have been reported in non-surgical cases including topical antibiotics/steroids, acetic acid, hydrogen peroxide, 5-fluorouracil, Castellani's paint, cautery, laser and surgery. Most of these, except surgery, are used in post-surgical cases.

It seems that most surgeons try a variety of treatments until the inflammation settles, which can take many months. There is no evidence for efficacy of any specific treatment. The most reasonable conclusion is that no specific treatment has been found to be effective in a significant proportion of patients.