Perforated Eardrum | Symptoms, Treatment and Causes

What is a perforated eardrum?

Dr Sarah Jarvis MBE

A perforated eardrum is a hole or tear that has developed in the eardrum. It can affect hearing. The extent of hearing loss can vary greatly. For example, tiny perforations may only cause minimal loss of hearing. Larger perforations may affect hearing more severely. Also, if the tiny bones (ossicles) are damaged in addition to the eardrum then the hearing loss would be much greater than, say, a small perforation which is not close to the ossicles.

With a perforation, you are at greater risk of developing an ear infection. This is because the eardrum normally acts as a barrier to bacteria and other germs that may get into the middle ear.

What is the eardrum and how do we hear?

Cross-section of the ear

The eardrum (also called the tympanic membrane) is a thin skin-like structure in the ear. It lies between the outer (external) ear and the middle ear.

The ear is divided into three parts – the outer, middle and inner ear. Sound waves come into the outer ear and hit the eardrum, causing the eardrum to vibrate.

Behind the eardrum are three tiny bones (ossicles). The vibrations pass from the eardrum to these middle ear bones. The bones then transmit the vibrations to the cochlea in the inner ear. The cochlea converts the vibrations to sound signals which are sent down a nerve to the brain, which we ‘hear’.

The middle ear behind the eardrum is normally filled with air. The middle ear is connected to the back of the nose by the Eustachian tube. This allows air in and out of the middle ear.

Perforated eardrum symptoms

There may be no symptoms, or there may be symptoms associated with the cause of the perforation – most often this is an infection.

Possible symptoms include:

• Changes in how you hear, that may range from slightly muffled to significant loss.
• Noises in your ear – buzzing or ringing (tinnitus).
• Aching or pain in your ear.
• Itching in your ear.
• Fluid leaking from your ear.
• A high temperature.

If your perforated eardrum is caused by a middle ear infection, you may have earache which suddenly gets worse when the drum perforates but then quickly gets better. This is because the perforation will allow pus to be released from behind the eardrum and relieves the pressure on the eardrum.

The symptoms will usually pass once your eardrum has healed and any infection has been treated.

Perforated eardrum causes

Causes include:

• Infections of the middle ear, which can damage the eardrum. In this situation you often have a discharge from the ear as pus runs out from the middle ear.
• Direct injury to the ear – for example, a punch to the ear.
• A sudden loud noise – for example, from a nearby explosion. The shock waves and sudden sound waves can tear (perforate) the eardrum. This is often the most severe type of perforation and can lead to severe hearing loss and ringing in the ears (tinnitus).
• Barotrauma. This occurs when you suddenly have a change in air pressure and there is a sharp difference in the pressure of air outside the ear and in the middle ear. For example, when descending in an aircraft. Pain in the ear due to a tense eardrum is common during height (altitude) changes when flying. However, a perforated eardrum only happens rarely in extreme cases. See the separate leaflet called Barotrauma of the Ear for more details.
• Poking objects into the ear. This can sometimes damage the eardrum.
• Grommets. These are tiny tubes that are placed through the eardrum. They are used to treat glue ear, as they allow any mucus that is trapped in the middle ear to drain out from the ear. When a grommet falls out, there is a tiny gap left in the eardrum. This heals quickly in most cases.

How is a perforated eardrum diagnosed?

A doctor can usually diagnose a torn (perforated) eardrum simply by looking into the ear with a special torch called an otoscope. However, sometimes it is difficult to see the eardrum if there is a lot of inflammation, wax or infection present in the ear.

Treatment for a perforated eardrum

No treatment is needed in most cases

A torn (perforated) eardrum will usually heal by itself within 6-8 weeks. It is a skin-like structure and, like skin that is cut, it will usually heal. In some cases, a doctor may prescribe antibiotic medicines if there is an infection or risk of infection developing in the middle ear whilst the eardrum is healing.

It is best to avoid water getting into the ear whilst it is healing. For example, your doctor may advise that you put some cotton wool or similar material into your outer ear whilst showering or washing your hair. It is best not to swim until the eardrum has healed.

Medical treatment

Occasionally, a perforated eardrum gets infected and needs antibiotics. Some ear drops can occasionally damage the nerve supply to the ear. Your doctor will select a type that does not have this risk, or may give you medication by mouth.

Surgical treatment is sometimes considered

A small operation is an option to treat a perforated drum that does not heal by itself. There are various techniques which may be used to repair the eardrum, depending on how severe the damage is. This operation may be called a myringoplasty or a tympanoplasty. These operations are usually successful in fixing the perforation and improving hearing.

However, not all people with an unhealed perforation need treatment. Many people have a small permanent perforation with no symptoms or significant hearing loss. Treatment is mainly considered if there is hearing loss, as this may improve if the perforation is fixed. Also, swimmers may prefer to have a perforation repaired, as getting water in the middle ear can increase the risk of having an ear infection.

If you have a perforation that has not healed by itself, a doctor who is an ear specialist will advise on whether treatment is necessary.

Eardrum (Tympanic Membrane) Perforation | Columbia University Medical Center Department of Otolaryngology Head and Neck Surgery

Eardrum (Tympanic Membrane) Perforation

What is an eardrum (tympanic membrane) perforation?

Tympanic membrane perforation, also known as a perforated eardrum, is a hole in the thin membrane that separates the ear canal from the middle ear.

What causes a tympanic membrane perforation?

A tympanic membrane perforation can have many causes. In people who have had ear tubes (tympanostomy tubes), a perforation can result when the eardrum does not close up after the tube comes out. While this is rare, it is seen from time to time. In other cases, frequent ear infections can cause a tympanic membrane perforation. During a middle ear infection (otitis media), pressure from pus under the tympanic membrane sometimes produces a small hole in the tympanic membrane. This is the body’s natural way of draining the pus and getting it out of the ear. Finally, traumatic injuries, like cotton swab (Q-Tip) use can cause a tympanic membrane perforation.

What are the symptoms of a tympanic membrane perforation?

A tympanic membrane perforation can cause problems, depending on the size of the hole and where the hole is in the eardrum.

Tympanic membrane perforations can cause a conductive hearing loss (where the sound does not reach the inner ear). In general, the larger the hole, the larger the hearing loss. A hearing test (audiogram) can easily check how much hearing loss there is.

Tympanic membrane perforations can cause ear infections. The middle ear (the space beneath the tympanic membrane) is not supposed to get wet from the outside world. If water gets into the middle ear, a middle ear infection (otitis media) can happen. The exception is that very small tympanic membrane perforations generally do not cause ear infections because not much water will travel through them. In these cases, very tiny tympanic membrane perforations act similar to permanent ear tubes.

How is a tympanic membrane perforation treated?

A new tympanic membrane perforation will usually heal itself. When the hole is formed, regardless of the reason, the body will try to heal it. However, sometimes, the perforation does not heal on its own. If the size of a tympanic membrane perforation has not gotten any smaller in about two months, it will probably not heal on its own.

In most, but not all, cases we recommend fixing tympanic membrane perforations. We particularly recommend this when there is a hearing loss or when the hole is causing infections. Fixing the hole can often fix these problems. An otologist can help you make this decision.

Repairing a tympanic membrane perforation involves a minor surgery. This is generally a routine, outpatient procedure that takes a couple of hours. Our surgeons make a cut inside the ear canal or behind the ear. The eardrum is then lifted up. A material is then used to patch the hole. Several materials can be used, depending on the exact situation. These include a small piece of cartilage, fascia (muscle lining), or synthetic materials. The eardrum is folded back down and some dissolvable packing is placed in the ear canal. You will usually go home a couple of hours after you wake up.

Surgeons at Columbia Otolaryngology are pioneering a new technique for repairing tympanic membrane perforations. In some situations, this can allow repairing the hole entirely through the ear canal, without making any visible incisions. This might result in faster healing and less pain. For more information, read about endoscopic ear surgery at Columbia.

Medicine, including ear drops and pills you take by mouth, will not fix a chronic (present for more than a couple of months) tympanic membrane perforation. If the perforation is recent, then sometimes antibiotic eardrops will be used to treat ear infections that occur along with it.

What do I do until my tympanic membrane perforation is fixed?

It is important to keep the ear dry. In all but the smallest perforations, water can travel through and cause a middle ear infection (otitis media). One simple way to keep the ear dry is to place a cotton ball soaked in petroleum ointment (e.g., Vaseline) on the outside of the ear canal during showering. Avoiding swimming is also recommended, although in some cases watertight earplugs can help.

Ask Dr. K: Perforated eardrums heal on their own

Anthony L. Komaroff

Universal Uclick

DEAR DOCTOR K: I have a perforated eardrum caused by an ear infection. How will it be treated? Will my hearing be permanently affected?

DEAR READER: Your eardrum is a thin membrane involved in hearing. It separates your ear canal (the part that is open to the outside) from your middle ear.

The eardrum is delicate – and it has to be. Sound waves that enter your ear move the eardrum, which begins the process that allows you to hear. If it weren’t thin and delicate, the eardrum wouldn’t vibrate so sensitively when sound waves hit it.

But because it is thin and delicate, it can be torn (perforated) easily. As in your case, it is most often torn by an ear infection. But other types of trauma, including a very loud noise, or even a cotton swab inserted into the ear during cleaning, can also damage it.

If the tear is small, your doctor may allow it to heal on its own. Most perforated eardrums heal in a few weeks to two months.

Exposure to water or further trauma can slow the healing. Use cotton balls covered with Vaseline to protect your eardrum from water during showers or baths. Also avoid blowing your nose: It increases pressure in your ear, and that can disrupt healing. If your ear gets infected during the healing phase, the tear is less likely to close on its own.

Ear, nose and throat doctors sometimes patch eardrum tears in their office. The doctor places a thin paper patch over the eardrum, along with a chemical that encourages the eardrum to heal.

If your eardrum has not healed after two months, your doctor may recommend tympanoplasty. In this procedure, the surgeon takes tissue from elsewhere in your body and uses it to close the hole or to fashion a new eardrum.

Hearing loss from a perforated eardrum is usually temporary. However, some people do permanently lose some level of hearing.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

Perforated Eardrum — Tui Ear Clinic

 perforated eardrums

A ruptured eardrum (tympanic membrane perforation) is a hole or tear in the thin tissue that separates your ear canal from your middle ear space.

This may be caused by loud sounds, a foreign object in the ear, head trauma, a middle ear infection or rapid pressure changes, such as from air travel, diving or sky diving.

Signs that you’ve perforated your eardrum

• A sharp pain in the affected ear that subsides quickly. If the pain is due to infection you will usually notice a blood stained discharge once the eardrum burst with significant relief in pain

• Discharge from the ear

• Ringing in the ear (tinnitus)

• Blocked feeling in the ear and/or hearing loss which is usually temporary and will resolve as the eardrum heals

• Feeling or sound of air coming out of the ear when blowing your nose

What to do if your eardrum has perforated

It is best to see a doctor or ear nurse as soon as possible. If it was caused by an accident or injury you will need to complete an ACC form.

Your ear canal may need to be cleaned, microsuctioning is safe and comfortable and the recommended way.

You may not need antibiotics or ear drops, it depends on how it happened. If there is infection or a high risk of infection (like diving into a river or lake) then you may require antibiotics and/or ear drops.

It will be very important to keep the affected ear dry to prevent water from entering the middle ear space and causing further irritation and or infection.

Followup visits are important until the perforation has healed. This may take anything from a few days to a few months. Usually if the eardrum has not healed itself after 3 months it may not do so at all and will be referred to as a chronic perforation. This may need referral to an ear nose and throat specialist.

You may also need to undergo a hearing test to determine if there is any permanent damage to your hearing, more so when it was caused by a loud noise or injury.

Eardrum perforation | Eardrum surgery

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​The eardrum is a small membrane at the end of the ear canal. The eardrum collects the sounds that come into the ear canal. 

These sound waves vibrate the eardrum; the sounds are then transmitted to the bones of hearing (ossicles). The eardrum also protects the middle ear so debris and bacteria do not enter the middle ear.

An eardrum perforation is a hole or opening in an otherwise intact eardrum. The size of the perforation can vary from a small pinpoint opening to a loss of the entire eardrum.

How does a perforation of the eardrum occur?

There are many ways an eardrum perforation can occur. An infection behind the eardrum in the middle ear may cause a rupture of the eardrum. Trauma to the ear may result from an object entering the ear canal and puncturing the eardrum. A traumatic blow to the ear with a cupped hand can rupture the eardrum. Hot welding slag can burn a hole through the eardrum. After a ventilation tube has been extruded or is removed, the opening usually closes; in some cases a permanent opening of the eardrum may occur. Chronic ear problems such as deep retraction pockets and
cholesteatoma​​ can weaken and erode the eardrum, resulting in a defect or perforation.

What problems may occur as a result of an eardrum perforation?

Debris, dirty water and bacteria may enter the middle ear through the perforation. This may result in an infection commonly associated with a discharge out of the ear. Most perforations are associated with hearing loss. The degree of hearing loss depends in part on the size of the perforation, the location of the perforation on the eardrum, and whether there is other pathology present in the ear. In some cases, skin can grow around the margins of the perforation, forming a skin cyst (cholesteatoma), in the middle ear and mastoid. However, in many patients with a perforation of the eardrum, the ear remains free of infection and can be safely left without surgical closure of the perforation.

What can be done to repair the perforation?

Some perforations will heal spontaneously without any surgical intervention. In some cases, a paper patch can be placed over the perforation as an office procedure to promote healing. Many times, surgery is required to close the perforation.

What is used to close the perforation?

In most cases, tissue is taken from above the ear and used as graft material. Beneath the skin above the ear is a muscle. The covering over this muscle is called fascia. A piece of fascia is removed through an incision above the ear. This does not produce any changes in the function of this muscle. The tissue (fascia) is laid into the ear and heals as the new eardrum. Some surgeons use other tissue such as vein, perichondrium (covering over cartilage), periosteum (covering over bone), or cadaver tissue.

What surgical approach is used to repair the eardrum?

There are two major approaches to the eardrum: transcanal and postauricular. In the postauricular approach, an incision is made behind the ear. The ear is reflected forward and the eardrum can be visualized. In the transcanal approach, a speculum is placed in the outer opening of the ear canal. The eardrum is visualized by working through the speculum.

What is done to repair the hole in the eardrum?

Once the surgeon has full view of the eardrum, the margins around the perforation are freshened with an instrument. This removes the rim around the perforation producing a raw circumferential edge of the remaining eardrum. Incisions are made in the ear canal skin; part of the ear canal skin, along with any remnant of good eardrum is elevated. The fascia is laid into the ear to cover the perforation on the underneath side of the eardrum. The canal skin is put back in place; the ear canal is packed and a cotton ball applied. The healing process takes about four to six weeks.

Are there any risks with this surgery?

Any surgical procedure carries potential risks. These risks are discussed with the patient and/or family prior to surgery.

• 
  Hearing loss: There is a slight chance of hearing loss in the inner ear. This loss can be complete and permanent.
• 
  Dizziness: Some patients experience dizziness that resolves within a day of surgery. It is not likely for dizziness to be a persistent problem.
• 
  Facial paralysis: The nerve that innervates the muscle of the face courses through the ear. Therefore, there is a slight chance of a facial paralysis. The facial paralysis affects the movement of the facial muscles for closing of the eye, making a smile and raising the forehead. The paralysis could be partial or complete. It may occur immediately after surgery or have a delayed onset. Recovery can be complete or partial.
• 
  Tinnitus: Tinnitus, or noises in the ear, can occur with surgery, but is an uncommon post-operative problem.
• 
  Taste abnormalities: A small nerve that innervates some of the taste and salivary function courses through the ear. After ear surgery, some patients experience an abnormal taste in the mouth or some dryness of the mouth. Many times, this problem will improve over time.

It is generally felt that the occurrence of these potential complications is less with surgeons who are well trained in otologic surgery, have experience in performing these surgeries and perform these procedures on a regular basis.

Along with these otologic risks, any surgery carries the risk of anesthesia, bleeding, infection and other more remote operative problems.

Are there any activity restrictions during the post-operative period?

It is important to keep water from entering the ear canal during the healing process. Cotton tip carriers or earplugs should not be placed into the ear, this may disrupt the healing process. The patient should not manipulate the ear even if there is an itching sensation; this may shear the small blood vessels needed for the healing process. The patient should not undergo any heavy physical activity in the post-operative period. Since each case is different, the patient’s surgeon should review the specific details regarding post-operative care. The recovery room nurses will go over a printed post-operative instruction sheet before the patient is discharged.

Is the operation performed in all age groups?

Yes, the surgery can be performed in children and adults.

What are the goals of this surgery?

There are two primary goals of surgery to repair the eardrum. First, to close the opening (perforation) in the eardrum. This protects the middle ear from the outside environment by producing an intact eardrum. Second, to maintain, preserve or restore the hearing. The operation is generally successful; but the surgeon can review the unique and specific issues with each patient depending upon the size of the perforation, other ear pathology and other factors that may have an impact on the outcome of the surgery.

Is the procedure done on an outpatient basis?

Yes. Virtually all tympanoplasty surgeries for repair of the eardrum, both for children and adults, are performed on an outpatient basis.

Is this a commonly performed surgery?

A tympanoplasty (repair of the eardrum) is one of the more commonly performed ear surgeries. As with any surgical procedure, each surgeon has their own variations of the technique. There are many factors that affect surgical results, including the amount of disease in the ear, patient healing factors, surgical technique, and the experience of the surgeon.

Types of eardrum perforations​

Perforation at margin of the eardrum

This is a perforation that occurs at the margin of the eardrum – where the eardrum and ear canal come together.

In some cases, skin from the ear canal can grow through the perforation into the middle ear, forming a cholesteatoma.

Central eardrum perforation

A perforation can occur in any location on the eardrum. The size of the perforation varies from a small opening like the one shown, to a total (entire) eardrum perforation.

Attic perforation of the eardrum

This is a perforation in the superior part of the eardrum. This is sometimes referred to as an attic perforation. A perforation in this location may be associated with a deep retraction pocket or cholesteatoma into the mastoid.

Ear Drum Perforations

A perforated or burst eardrum is a hole in the eardrum. It will usually heal within a few weeks and might not need any treatment.

But it’s a good idea to see your GP if you think your eardrum has burst, as it can cause problems such as infections or hearing loss.

Symptoms of a perforated eardrum

Signs of a perforated eardrum or ear infection include:

• Sudden hearing loss – you may find it difficult to hear anything or your hearing may just be slightly muffled 
• Pain in your ear 
• Itching in your ear 
• Fluid leaking from your ear 
• A high temperature (fever) of 38C (100.4F) or above 
• Ringing or buzzing in your ear 

The symptoms will usually pass once your eardrum has healed and any infection has been treated.

When to see your GP

See your GP if:

• You think you have a perforated eardrum 
• You’ve already seen your GP and your symptoms aren’t any better after a few weeks or you get new symptoms (such as earache, a fever, itching or fluid leaking from the ear) 

Your eardrum will usually heal without treatment, but your specialist can check for an infection (which may need treatment) and talk to you about how you can look after your ear.

Treatments for a perforated eardrum

Perforated eardrums don’t always need to be treated because they often get better by themselves within a few weeks.

While it heals, the following tips can help you relieve your symptoms and reduce the chances of your ear becoming infected:

• Don’t put anything in your ear, such as cotton buds or eardrops (unless your doctor recommends them) 
• Don’t get water in your ear – don’t go swimming and be extra careful when showering or washing your hair 
• Try not to blow your nose too hard, as this can damage your eardrum as it heals 

If the hole in your eardrum is big or doesn’t heal in a few weeks, your GP may refer you to an ear specialist to talk about having surgery to repair it.

Causes of a perforated eardrum

A hole in the eardrum can be caused by:

• An ear infection 
• An injury to the eardrum, such as a blow to your ear or poking an object like a cotton bud deep into your ear 
• Changes in air pressure, such as while flying or scuba diving 
• A sudden loud noise, such as an explosion 

The following tips may help you avoid damaging your eardrum:

• See your GP for treatment if you have symptoms of an ear infection for more than two or three days 
• Don’t push anything deep into your ears, including your fingers 
• Wear suitable ear protection if you’re often exposed to loud noises 
• When flying, try swallowing, yawning, chewing gum or sucking on a boiled sweet during take-off and landing

Reference; NHS patient information series, 2019.

Ruptured eardrum (perforated eardrum) // Middlesex Health

Overview

A ruptured eardrum (tympanic membrane perforation) is a hole or tear in the thin tissue that separates your ear canal from your middle ear (eardrum).

A ruptured eardrum can result in hearing loss. It can also make your middle ear vulnerable to infections.

A ruptured eardrum usually heals within a few weeks without treatment. But sometimes it requires a patch or surgical repair to heal.

A ruptured (perforated) eardrum prevents the proper transmission of sound waves to the middle ear and leaves the middle ear vulnerable to infectious agents, water and other foreign substances.

Symptoms

Signs and symptoms of a ruptured eardrum may include:

• Ear pain that may subside quickly
• Mucuslike, pus-filled or bloody drainage from your ear
• Hearing loss
• Ringing in your ear (tinnitus)
• Spinning sensation (vertigo)
• Nausea or vomiting that can result from vertigo

When to see a doctor

Call your doctor if you experience signs or symptoms of a ruptured eardrum. Your middle and inner ears are made up of delicate structures that are sensitive to injury or disease. It is important to try to figure out the cause of your ear symptoms and determine whether a ruptured eardrum has occurred.

Causes

Causes of a ruptured (perforated) eardrum may include:

• Middle ear infection (otitis media). A middle ear infection often results in the accumulation of fluids in your middle ear. Pressure from these fluids can cause the eardrum to rupture.

• Barotrauma. Barotrauma is stress exerted on your eardrum when the air pressure in your middle ear and the air pressure in the environment are out of balance. If the pressure is severe, your eardrum can rupture. Barotrauma is most often caused by air pressure changes associated with air travel.

  Other events that can cause sudden changes in pressure — and possibly a ruptured eardrum — include scuba diving and a direct blow to the ear, such as the impact of an automobile air bag.

• Loud sounds or blasts (acoustic trauma). A loud sound or blast, as from an explosion or gunshot — essentially an overpowering sound wave — can rarely cause a tear in your eardrum.
• Foreign objects in your ear. Small objects, such as a cotton swab or hairpin, can puncture or tear the eardrum.
• Severe head trauma. Severe injury, such as a skull base fracture, may cause the dislocation of or damage to middle and inner ear structures, including your eardrum.

The middle ear includes three small bones — the hammer (malleus), anvil (incus) and stirrup (stapes). The middle ear is separated from your external ear by the eardrum and connected to the back of your nose and throat by a narrow passageway called the eustachian tube. The cochlea, a snail-shaped structure, is part of your inner ear.

Complications

Your eardrum (tympanic membrane) has two primary roles:

• Hearing. When sound waves strike it, your eardrum vibrates — the first step by which structures of your middle and inner ears translate sound waves into nerve impulses.
• Protection. Your eardrum also acts as a barrier, protecting your middle ear from water, bacteria and other foreign substances.

If your eardrum ruptures, uncommon problems can occur, especially if it fails to self-heal after three to six months. Possible complications include:

• Hearing loss. Usually, hearing loss is temporary, lasting only until the tear or hole in your eardrum has healed. The size and location of the tear can affect the degree of hearing loss.
• Middle ear infection (otitis media). A ruptured (perforated) eardrum can allow bacteria to enter the ear. If a perforated eardrum doesn’t heal, a small number of people may be vulnerable to ongoing (recurrent or chronic) infections. In this small group, chronic drainage and hearing loss can occur.

• Middle ear cyst (cholesteatoma). Although very rare, this cyst, which is composed of skin cells and other debris, can develop in your middle ear as a long-term result of eardrum rupture.

  Ear canal debris normally travels to your outer ear with the help of ear-protecting earwax. If your eardrum is ruptured, the skin debris can pass into your middle ear and form a cyst.

  A cyst in your middle ear provides a friendly environment for bacteria and contains proteins that can damage the bones of your middle ear.

Prevention

Follow these tips to avoid a ruptured (perforated) eardrum:

• Get treatment for middle ear infections. Be aware of the signs and symptoms of middle ear infection, including earache, fever, nasal congestion and reduced hearing. Children with middle ear infections often are fussy and may refuse to eat. Seek prompt evaluation from your primary care doctor to prevent potential damage to the eardrum.

• Protect your ears during flight. If possible, don’t fly if you have a cold or an active allergy that causes nasal or ear congestion. During takeoffs and landings, keep your ears clear with pressure-equalizing earplugs, yawning or chewing gum.

  Or use the Valsalva maneuver — gently pushing air into your nose, as if blowing your nose, while pinching your nostrils and keeping your mouth closed. Don’t sleep during ascents and descents.

• Keep your ears free of foreign objects. Never attempt to dig out excess or hardened earwax with items such as a cotton swab, paper clip or hairpin. These items can easily tear or puncture your eardrum. Teach your children about the damage that can be done by putting foreign objects in their ears.
• Guard against explosive noise. Avoid activities that expose your ears to explosions. If your hobbies or work involves planned activities that produce explosive noise, protect your ears from unnecessary damage by wearing protective earplugs or earmuffs.

Diagnosis

Your family doctor or ENT specialist can often determine if you have a ruptured (perforated) eardrum with a visual inspection using a lighted instrument (otoscope or microscope).

He or she may conduct or order additional tests to determine the cause of your ear symptoms or to detect the presence of any hearing loss. These tests include:

• Laboratory tests. If there’s discharge from your ear, your doctor may order a laboratory test or culture to detect a bacterial infection of your middle ear.

• Tuning fork evaluation. Tuning forks are two-pronged, metal instruments that produce sounds when struck. Simple tests with tuning forks can help your doctor detect hearing loss.

  A tuning fork evaluation may also reveal whether hearing loss is caused by damage to the vibrating parts of your middle ear (including your eardrum), damage to sensors or nerves of your inner ear, or damage to both.

• Tympanometry. A tympanometer uses a device inserted into your ear canal that measures the response of your eardrum to slight changes in air pressure. Certain patterns of response can indicate a perforated eardrum.
• Audiology exam. This is a series of strictly calibrated tests that measure how well you hear sounds at different volumes and pitches. The tests are conducted in a soundproof booth.

Treatment

Most ruptured (perforated) eardrums heal without treatment within a few weeks. Your doctor may prescribe antibiotic drops if there’s evidence of infection. If the tear or hole in your eardrum doesn’t heal by itself, treatment will likely involve procedures to close the tear or hole. These may include:

• Eardrum patch. If the tear or hole in your eardrum doesn’t close on its own, an ENT specialist may seal it with a paper patch (or a patch made of other material). With this office procedure, your ENT doctor may apply a chemical to the edges of the tear, which can promote ear drum healing, and then apply a patch over the hole. The procedure may need to be repeated more than once before the hole closes.
• Surgery. If a patch doesn’t result in proper healing or your ENT doctor determines that the tear isn’t likely to heal with a patch, he or she may recommend surgery. The most common surgical procedure is called tympanoplasty. Your surgeon grafts a patch of your own tissue to close the hole in the eardrum. This procedure is done on an outpatient basis. In an outpatient procedure, you can usually go home the same day unless medical anesthesia conditions require a longer hospital stay.

In some cases, your surgeon treats a ruptured eardrum with a procedure called tympanoplasty. Your surgeon grafts a tiny patch of your own tissue to close the hole in the eardrum.

Lifestyle and home remedies

A ruptured (perforated) eardrum usually heals on its own within weeks. In some cases, healing takes months. Until your doctor tells you that your ear is healed, protect it by:

• Keeping your ear dry. Place a waterproof silicone earplug or cotton ball coated with petroleum jelly in your ear when showering or bathing.
• Refraining from cleaning your ears. Give your eardrum time to heal completely.
• Avoiding blowing your nose. The pressure created when blowing your nose can damage your healing eardrum.

Preparing for an appointment

If you have signs or symptoms of a perforated eardrum, you’re likely to start by seeing your family doctor or general practitioner. However, your doctor may refer you to a specialist in ear, nose and throat (ENT) disorders (otolaryngologist).

Here’s some information to help you prepare for your appointment.

What you can do

Make a list ahead of time that you can share with your doctor. Your list should include:

• Symptoms you’re experiencing, including any that may seem unrelated to hearing loss, fluid discharge or other ear-related symptoms
• Relevant events that may be related to your ear problems, such as a history of ear infections, recent ear injuries or head traumas, or recent air travel
• Medications, including any vitamins or supplements you’re taking
• Questions for your doctor

If you think you have signs or symptoms of a ruptured eardrum, you may want to ask your doctor some of the following questions.

• Do I have a ruptured eardrum?
• What else could be causing my hearing loss and other symptoms?
• If I have a ruptured eardrum, what do I need to do to protect my ear during the healing process?
• What type of follow-up appointments will I need?
• At what point do we need to consider other treatments?

Don’t hesitate to ask other questions you have.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

• When did you first experience symptoms?
• Did you have symptoms such as pain or vertigo that cleared up?
• Have you had ear infections?
• Have you been exposed to loud sounds?
• Have you been swimming or diving recently?
• Have you recently flown?
• Have you had head injuries?
• Do you put anything in your ear to clean it?

What you can do in the meantime

If you think that you have a ruptured eardrum, be careful to keep your ears dry to prevent infection. Don’t go swimming until your condition has been evaluated and discussed with your doctor. To keep water out of your ear when showering or bathing, use a moldable, waterproof silicone earplug or put a cotton ball coated with petroleum jelly in your outer ear.

Don’t put medication drops in your ear unless your doctor prescribes them specifically for infection related to your perforated eardrum.

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One of the causes of hearing loss is rupture, trauma, perforation of the eardrum.The eardrum is a unique part of the human auditory system. It is fragile and thin, it is easy to damage it and at the same time it is able to perceive vibrations of sounds and transmit them further into the inner ear. The eardrum is a kind of checkpoint between the outer and middle ear, which does not allow water, dust, or even air to enter the middle ear. It separates the outer ear from the middle ear.

Eardrum functions:

Protects the middle ear from air, moisture, dust.If the tympanic membrane is damaged, these substances can enter the middle ear and cause harm in the form of infectious diseases and their consequences.

The membrane picks up sound vibrations and transmits them to the inner ear. It is quite logical that when a membrane ruptures, a person’s hearing decreases. The bad news is that hearing doesn’t always come back after tightening the hole.

If the eardrum bursts, then if you do nothing, the following may happen:

– infection in the middle ear

– ringing and noise in the ear

– hearing loss

see a doctor, because only a doctor can prescribe appropriate and professional treatment.A doctor who can help solve this problem is popularly called an ENT, and in the medical world his name is an otolaryngologist. The biggest mistake people make when perforating the tympanic membrane is to ask for advice from sofa experts, since they “know for sure” whether it is possible to restore the eardrum, or you can drop drops and everything will go away … Do not repeat the mistakes of others – contact medical doctors immediately. specialists.

Why do tympanic membrane perforations occur?

This phenomenon can occur at any age, both with adults and with children.

• Mechanical damage.

Can occur when cleaning the ears with objects that are not intended for this at all – pencils, paper clips, cotton swabs, etc. sticks and the purpose in them is just cosmetic), especially for children. One wrong movement or one jerk or a sharp turn of the child’s head and – hello, perforation of the eardrum!

• Acoustic trauma.

Most often concerns two categories of people: military and music lovers. The former can get acoustic trauma during shooting, explosions, and military operations. Music lovers while enthusiastically listening to music at a concert in a close distance from the speaker or at a disco with an overwhelming volume level. In both cases, this is what happens – too powerful a sound wave easily tears apart the thin tissue of the tympanic membrane of the human ear.

Trauma from a pressure difference between the external environment and the internal cavity.The membrane becomes very stressed under pressure and can rupture. Most often, this type of injury occurs during diving in a person who is diving under water, during an airplane take off for passengers, during boxing from an enemy strike and even from a sudden deployment of an airbag in a car.

• Middle ear infection.

During illness, fluid can build up in the middle ear, which puts pressure on the eardrum and damages it.When there is too much fluid, it breaks out, damaging the membrane.

• Traumatic brain injury.

Leads to rupture of the tympanic membrane when a fracture of the skull and other damage to the middle and inner ear occurs.

How to recognize a ruptured eardrum?

• sharp pain in the ear.

Acute pain syndrome. This is the main and obligatory symptom. The pain comes on suddenly and can disappear just as suddenly.

• hearing loss.

It can be noticed subjectively, without special examination.

• dizziness.

Occurs with hearing loss. this is due to the work of the vestibular apparatus.

• leakage of pus and other fluid from the ear.

This can occur with purulent otitis media. In this case, at the moment of rupture, the pain is not as strong as in the case of mechanical damage.

A person notices and feels these symptoms himself, but the final diagnosis can only be made by a specialist – an otolaryngologist.With the help of a special device with illumination – an otoscope, he can see the gap, determine its size, and determine the general condition of the membrane. And, accordingly, the doctor must prescribe treatment.

Eardrum restoration is perceived by most people like: “Yes, it will heal itself”, do not attach much importance to this process and neglect the health of their hearing organs. The restoration of the ear membrane should only take place on the recommendation of a doctor and under his supervision, or even his hands.Before visiting the doctor, prepare the questions that interest you: How long does the healing process take? can the eardrum be restored? Will the eardrum be replaced and is it possible?

Types of help for membrane perforation:

When the doctor sees that the membrane does not heal on its own, he recommends auxiliaries

• drug treatment.

Used most often for diseases of the middle ear, which led to a violation of the integrity of the tympanic membrane.

• so-called patching.

In this case, the doctor applies a special substance through the microscope and the auditory canal, which serves as a kind of plaster and promotes the healing of the tympanic membrane.

Medical professional name – tympanoplasty. The surgery is easy. The patient can be at home on the same day.

Preventive Actions

– Wear ear and hearing protection when in noisy environments, especially during hostilities, during concerts, discos, etc…

– when the pressure of the external environment and the middle ear changes, the use of earplugs is also recommended, that is, when diving under water, when flying, and the like.

– Stop cleaning your ears with objects that are intended for very different purposes.

– do not delay the treatment of infectious diseases of the inner ear. Timely treatment of these diseases is a real opportunity to prevent rupture of the tympanic membrane.

So, perforation of the eardrum is not a trifle, but a problem that can have unpleasant and irreversible consequences, especially for a person’s hearing level.Timely appeal to specialists, implementation of their recommendations is a chance that everything will end with a happy end. But, it is better to take preventive measures so that it doesn’t even start!

Take care of yourself and your hearing!

Tympanic membrane perforation | Centro Coromina

Tympanic membrane perforation | Centro Coromina – Dr. Jordi Coromina

Small hole in the tympanic membrane

Large hole in the tympanic membrane

Perforation of the tympanic membrane

Perforation of the tympanic membrane (the presence of a rupture or hole in it) can be caused by various reasons 9063 One or more:

previous acute otitis media
• Very loud noise (fireworks, explosion, etc.)
• Impact on the ear (slap, etc.)
• Sudden pressure drops (immersion in water, etc.)
• Cleaning the ears with cotton swabs or sharp objects

Symptoms

Observed symptoms:

• Loss hearing
• In some cases, discharge from the ear or noise in the ear

A ruptured eardrum is diagnosed on the basis of microscopic examination of the ear. Audiometry is also done to assess the degree of hearing loss.

Treatment

Treatment depends on the size of the perforation. If the hole is small, you need to wait 6 months for it to heal on its own. In the case of a large or non-healing opening, a skin graft is performed on a perforated eardrum. This operation is called myringoplasty or tympanoplasty.

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symptoms in adults, what is it, what does perforated mean, how long does it take to heal, signs, treatment with Otofy and Normax

Perforation of the tympanic septum is a pathological process in which a violation of the septum occurs.And it arises as a result of the development of the inflammatory process, mechanical influence and the difference in pressure outside and inside the ear cavity. Eardrum perforation is a condition in which there is an opening or tear in the membrane, which contributes to an infection in the middle ear. If you do not start treating the pathology, then this is fraught with the development of otitis media.

Symptoms

You can recognize the disease by the following symptoms:

• Painful sensations in the ear, which are acute;
• spotting during trauma;
• discharge of a purulent character, which is the result of otitis media;
• subsiding of pain syndrome when fluid breaks through the membrane;
• ringing in the ears;
• hearing impairment.

Often, the pathological process leads to the development of complications, which include hearing loss, permanent deafness, chronic otitis media, rupture of the membrane. Complications arise as a result of the penetration of the infectious process into other tissues.

In the video – perforation of the tympanic membrane:

Views

First of all, the classification of the preformation of the tympanic membrane involves the division of pathology into central and marginal types.The first variant of the pathological process occurs against the background of chronic otitis media. By location, the perforation is subdivided into lower back and front. But the marginal perforations are characterized by bone damage and are combined with granulations and the formation of cholesteatoma.

In the picture – membrane perforation

In medical practice, you can hear such a term as dry perforation of the tympanic membrane. If it is present, the patient’s hearing deteriorates sharply. Pathology occurs against the background of a chronic infectious process.It can also be the cause of the development of cicatricial otitis media.

Perforation can be acute or chronic downstream. The acute process is characterized by severe pain, fever and temporary hearing loss. If the treatment was provided on time, the patient will feel an improvement within 1-2 weeks. But the chronic process is the result of out-of-date therapy for acute inflammation. It proceeds in two stages – remission and exacerbation. During remission, the symptoms are not pronounced, but with an exacerbation, all the symptoms return.If left untreated, chronic perforation of the eardrum will lead to permanent hearing loss.

Conservative treatment

The drawn up scheme of therapy should be aimed at arresting the inflammatory process in the middle ear. For patients who have this problem, it is worth protecting the ear from water, as well as adhering to the hygiene of the ear canal. For these purposes, it is required to wipe the ear area using a sterile cotton swab moistened with alcohol, and then close the passages with a clean and dry cotton swab.

If purulent otitis media occurs, then treatment will necessarily involve drops with an antibacterial effect.

The most effective are Normaks, Otofa and Tsipromed.

Normax

Otof’s drops contain a powerful antibiotic rifamycin. For adults, drip 4-5 drops into each ear.

Otofa

Drops for ears Tsipromed contains ciprofloxacin. The drug is used in the treatment of a purulent process.Apply 5 drops to each ear. During pregnancy and children under 15 years of age, the drug is prohibited.

Drops for ears Tsipromed

Drops Normax contains norfoxacin . It is an antibiotic that successfully treats pathogenic microorganisms.

The considered preparations do not have a toxic effect, as a result of which the innervation of the ear is not damaged.

But such drugs as Gazaron, Otinum ear drops, Polydex contain ototoxic antibiotics.It is strictly forbidden to use them for perforating the eardrum.

Gazaron

Surgical treatment

It is the membrane that plays a protective role and prevents infection from entering the brain. If, after the treatment provided, it does not completely drag on, then radical measures will need to be taken. It is necessary to perform the operation with the following indications:

• Complete rupture of the tympanic membrane;
• partial hearing loss;
• impaired mobility of the auditory ossicles.

With perforation of the tympanic membrane, the following types of surgery can be used:

1. Myringoplasty . The torn portion of the membrane will be replaced with a piece of the temporalis muscle sheath. It is sewn up with threads, the resorption of which occurs after 2-3 weeks.
1. Ossiculoplasty . This type of surgery will restore the auditory ossicles, as the damaged areas are replaced with prostheses.Local anesthesia is involved.
2. Tympanoplasty . It involves the removal or insertion of the piece-shaped auditory ossicles. An operation is performed when the mobility and integrity of the auditory ossicles is impaired.

What complications in the ears after a sore throat can be, this information will help to understand.

How to choose drops in the ears for otitis media and how to choose what would be the best result, this article will help you understand.

Why there is a rumble in the ears and lays them in, is described in great detail in this article: https: // prolor.ru / u / lechenie-u / gul-v-ushax-prichiny.html

What could be the reasons that the ears are itchy inside and how can this problem be dealt with.

Peculiarities of treatment of children

In the treatment of the pathological process in children, drugs can be used, thanks to which it is possible to stop inflammation and speed up the healing of the tympanic membrane. It is necessary to use drops, in the development of which antibiotics and steroid anti-inflammatory drugs were used.The following medicines are considered effective:

1. Otipax. These drops contain lidocaine. They are used to relieve pain. Due to the presence of a steroid in the composition, it is possible to remove inflammation from the membrane. In case of otitis media, you need to drip 1 drop into the affected ear. But how to properly bury Otipax drops in your ears, this article will help you understand.

   Otipax

2. Otofa . This is an effective drug that contains a broad-spectrum antibiotic.It does not relieve pain, but only relieves inflammation. For those who want to learn more about drops in Otof’s ears, you should follow the link and read the contents of this article.

   Otofa

3. Sofradex. The preparation contains neomycin. It gets into the inner ear, which has a toxic effect on the cells. But what is the price of Sofradex ear drops, this article will help you understand.

   Sofradex.

4. Cardibiotic . This is a drug that has a complex effect.It contains several antibiotics at once. It must be taken with caution, as allergies may occur.

   Cardibiotic

5. Amoxicillin. This medicine has a bactericidal and antibacterial effect. The therapy can last no longer than 7 days. And for those who want to know whether it is possible to drink Amoxicillin for a cold, you should follow this link.

   Amoxicillin

How long does it take to heal

The timing of healing depends on various factors.If the inflammation covers a large area, then the healing process will take longer. Poor healing pathologies in which fluid enters the ear cavity. In total, the duration of the disease is 2-6 weeks.

Perforation of the tympanic membrane is a pathological process that can have an acute and chronic course. It affects all people, regardless of age and gender. Treatment necessarily includes antibiotics, since the main task of therapy is to stop the inflammatory process.

Problems of otitis media

Despite significant difficulties, otitis media is successfully treated.

Diagnosis and treatment of otitis media – inflammation limited to the tympanic bladder – presents significant challenges for the veterinarian. Among other things, the sensitivity of the diagnostic study is not high enough, and the choice of treatment methods is limited by the problem of ototoxicity. If we add that otitis media is often chronic and is associated with Pseudomonas aeruginosa infection, we can admit that you are faced with a difficult case.

Otitis media in pets often goes undiagnosed; in 16% of dogs it is combined with acute otitis externa, and in 50% with chronic otitis externa. It should be included in the list of differential diagnoses for animals with chronic or recurrent otitis externa. An infected tympanic bladder can serve as a reservoir for bacteria and yeast that can re-infect the ear canal. Animals with otitis media usually shake their heads, have profuse exudate in the ear canal and pain on palpation – symptoms that are also common with otitis externa.There may be pain when chewing or opening the jaws due to the proximity of the temporomandibular joint to the tympanic bladder. The inflammation can damage the nerves passing through or in the vicinity of the tympanic bladder. In case of damage to the eardrum, sclerosis of the ossicles and accumulation of fluid, exudate or tissue in the tympanic bladder, hearing impairment is possible due to air conduction. Otitis media can progress to internal otitis media (inflammation of the inner ear), leading to damage to the peripheral vestibular apparatus and deafness.

Pathogenesis

In dogs, otitis media most often develops as a consequence of otitis externa. The thin eardrum can become porous or rupture due to infection, inflammation, or foreign bodies. Unlike the external auditory canal, the tympanic bladder is lined with respiratory epithelium. The inflammation leads to increased mucus production. The most common organisms isolated from the middle ear of dogs are Pseudomonas aeruginosa and Staphylococcus intermedius .It is likely that repeated use of sub-optimal topical or systemic antibiotics has increased the prevalence of resistant organisms in dogs with otitis media. In mixed infections, Malassezia pachydermatis is often present, reflecting the high incidence of otitis externa caused by this microorganism.

Ascending otitis media is more common in cats, thought to be associated with an upper respiratory infection. Staphylococcus intermedius is the most common microorganism isolated from the middle ear of cats.Infections with Cryptococcus neoformans may also present with otitis media / otitis media.

The tympanic bladder may be filled with mucus, pus, inflamed polyps, granulomatous material, or calcified material (otoliths). Damage to the nerves adjacent to the tympanic bladder or if infection spreads into the cranial cavity may cause neurological symptoms.7

Diagnosis of otitis media

Otitis media is diagnosed by clinical signs, the integrity of the tympanic membrane, as well as by visual diagnostic methods.In acute illness, X-ray images may show changes such as poor visibility of the horizontal ear canal due to swelling, and in chronic disease, linear calcification of the outer ear tissues. In the middle ear, changes may be absent, or there are signs of wall lysis, a thickening of the tympanic bladder, sclerosis, or an increase in the radiopacity of the lumen. Often these changes go unnoticed, but high-quality X-rays showing the structures of the inner ear show signs of sclerosis or blurred labyrinth contours.Remember that the skull is bilaterally symmetrical, so a loss of symmetry is often indicative of disease. Computed tomography (CT) is a more accurate and reliable method for diagnosing otitis media than X-rays, but in mild forms, both methods are less accurate and reliable than in more severe forms.8 Magnetic resonance imaging, when available, is better suited for visual diagnosis of soft tissue structures or neoplasms, but CT is better at detecting bone changes.

Fig.1 Dog of the griffin breed. The contents of the tympanic cavities are filled with exudate, the external auditory canal is not filled with air.
Fig. 2 French Bulldog with vestibular symptoms.

On the right, a lesion of the tympanic cavity is visualized, a thickening of the bone of the tympanic cavity (thick arrow) compared to the left side (thin arrow). There is practically no entrance to the tympanic cavity (curly arrow).

Fig. 3 The same dog. Inflammatory exudate, bone structures are poorly visualized.

But the sequence of programs FLAIR, T2 T1 and contrasting allows for differential diagnosis between inflammation and neoplasm, as well as assessing the presence of an inflammatory process in the nervous system (Fig. 4).

A. Inflammatory process in the tympanic cavity caused inflammation of the meninges of the brain (arrow).
C. The accumulation of contrast indicates an inflammatory process (curly arrow), it is necessary to compare Figures B and C.
G. Inflammatory cerebral edema.

Middle ear nerves

Some of the nerves are closely related to the middle ear:

• Internal carotid nerves provide the sympathetic postganglionic innervation of the eye and orbit. In cats, they are located under the mucous membrane, so they are easily damaged, which leads to Horner’s syndrome (enophthalmos, ptosis and miosis) (Fig. 5).
• Facial nerve. Damage to the facial nerve can lead to blepharospasm and paralysis of the auricle or facial muscles.
• The tympanic branch of the glossopharyngeal nerve transmits pain and pressure impulses from the middle ear.

Fig. 5 Horner’s syndrome.

Fig. 6 Anatomy of the nerves and blood vessels of the head.

The external carotid (carotid) artery (red arrow) and the maxillary vein (blue arrow) are located ventrally relative to the horizontal canal (yellow arrow).The facial nerve (green arrows) surrounds two to thirds of the canal ventrally (Fig. 6).

Video Damage to the facial nerve.

Definition of rupture of the tympanic membrane

A visual inspection of the ear canal and membrane is often sufficient to determine if the tympanic membrane is damaged. Tears of the stretched part of the membrane, mucus in the horizontal ear canal, or the visibility of the medial part of the tympanic bladder are signs of a torn or missing tympanic membrane.Usually, these changes can only be seen after flushing the external auditory canal. An intact tympanic membrane does not rule out otitis media, as sometimes membrane ruptures heal despite the presence of an infection in the tympanic bladder. It is often difficult to see the eardrum due to pathological changes.

Several techniques can be used to further explore. All of them require anesthesia with the installation of an endotracheal tube. Using the tip of a blunt polypropylene catheter, very carefully palpate the eardrum while looking at it through the otoscope.The eardrum will flex with gentle pressure and spring slightly except medially. Ear canalography with contrast can be used to more reliably diagnose a ruptured tympanic membrane (compared with otoscopy). Or (with the animal on its side), you can enter a saline solution into the ear canal and see if air bubbles rise from the rupture.

A myringotomy incision is made on the ventrocaudal side of the tensioned portion using a polypropylene catheter for cats cut with a scalpel blade at a 45 degree angle.When doing this, care must be taken not to damage the handle of the hammer. Anesthesia and good visualization are required.

Healing of the tympanic membrane

Perforated tympanic membrane in dogs normally takes several weeks to several months to heal. With existing pathological changes (infection, maceration, chronic outflow from the middle ear, excess sulfur or accumulated hair), healing may slow down or become impossible. If only a fragment remains of the tympanic membrane at the site of attachment to the ear canal (annulus fibrosus), its restoration is unlikely.In such animals, a permanent opening remains through which the middle ear communicates with the environment, which requires regular washing of the tympanic bladder under anesthesia. This ear must be protected from water when bathing and the animals must not be allowed to swim.

Non-ototoxic earwash solutions (eg TrizEDTA, DermaPet®; P1 / O, Glen-Haven ™) should be prescribed. Since the cells of the germ layer of the ear canal are found in the tympanic membrane, one should not expect effective self-cleaning of the ear canal.

Treatment of otitis media

Therapy for otitis media is similar to therapy for external, but is complicated by several factors. The inflamed respiratory epithelium lining the tympanic bladder secretes a large amount of fluid that, constantly oozing out, slows down the healing of the tympanic membrane. If the eardrum is intact, a myringotomy is performed to access the middle ear and drain. First, you need to take a sample for cytological examination and culture.If fluid is not present, flush the tympanic bladder with 1 ml of sterile saline through a polypropylene catheter, then inject the solution into the tympanic bladder and aspirate several times until the solution is clear. Bacteria isolated from the tympanic membrane are often different from those found in the horizontal ear canal.2 Non-toxic aqueous drugs (eg, dexamethasone sodium phosphate, enrofloxacin, and miconazole) can be injected directly into the tympanic bladder. Baytril ® Otic Emulsion, although not approved for ruptured tympanic membrane, is recognized as safe by many veterinary dermatologists.Ointment should not be injected into the middle ear.

Primary secretory otitis media with intact protruding tympanic membrane

For otitis externa / otitis media, systemic therapy should be prescribed. Corticosteroid therapy can reduce inflammation and secretion in the tympanic bladder and ear canal. Data on systemic antibiotic and antifungal therapy are conflicting; these drugs should be prescribed on a case-by-case basis based on culture and antibiotic susceptibility testing, taking into account the severity of the disease and the owner’s ability to carry out topical treatments.Systemic fluoroquinolones should be prescribed at a dose corresponding to the upper limit of the approved range, since their effect depends on the concentration (i.e., the peak concentration is more important than the duration of exposure to the drug at a concentration above the minimum inhibitory concentration). The use of doses below the therapeutic dose is highly likely to lead to the selection of microorganisms in the direction of increasing resistance. Additionally, anti-inflammatory doses of glucocorticoids (0.5 mg / kg / day) during the first 5-7 days of treatment can reduce inflammatory changes in the vestibulocochlear, facial, or sympathetic nerves.

Conclusion

Successful treatment of otitis media / otitis externa often requires continuous therapy for several months. The animal should be examined weekly and the middle ear should be rinsed regularly if indicated on examination. It is necessary to make a video recording with a video otoscope in order to show them to the owner and assess the dynamics of the condition in the future. Despite the obstacles and the importance of strict adherence to the owner’s recommendations, the prognosis for drug treatment of otitis media is favorable.It has been reported that washing the tympanic bladder in combination with drug treatment has resulted in a successful cure of 36/44 dogs regardless of age, Pseudomonas aeruginosa , or duration of otitis media before admission to the clinic.

Complete ear canal ablation and / or tympanic bladder osteotomy should be considered at:

1. irreversible complete stenosis of the ear canal
2. Osteomyelitis of the tympanic bladder
3. ineffectiveness of drug therapy or
4. complete deafness when surgical treatment can provide the animal with a better quality of life.

Primary secretory otitis media in Cavalier King Charles Spaniels

In most dogs, otitis media develops as a consequence of external. However, Cavalier King Charles Spaniels have primary secretory otitis media.

Animals have moderate to severe soreness or itching in the neck or head. Additional neurological symptoms are sometimes present.

On otoscopy, the external auditory canal appears normal, but a protruding, intact tympanic membrane is often visible.Myringotomy reveals viscous mucus without pronounced cytological changes.

After washing the tympanic bladder, relapses often develop, requiring repeated myringotomy. An alternative tympanostomy method has recently been described with a permanent drainage through the tympanic membrane.

Literature

1. Little CJ, Lane JG, Pearson GR. Inflammatory middle ear disease of the dog: the pathology of otitis media, Vet Rec. 1991; 128 (13): 293-296.
2. Cole LK, et al.Microbial flora and antimicrobial susceptibility patterns of isolated pathogens from the horizontal ear canal and middle ear in dogs with otitis media. J Am Vet Med Assoc. 1998; 212 (4): 534-538.
3. Brothers AM, Gibbs PS, Wooley RE. DevelopmentBanfield
4. of resistant bacteria isolated from dogs with otitis externa or urinary tract infections after exposure to enrofloxacin in vitro. Vet Ther. 2002; 3 (4): 493-500.
5. Beatty JA, et al. Peripheral vestibular disease associated with cryptococcosis in three cats.J Feline Med Surg. 2000; 2 (1): 29-34.
6. Fliegner RA, Jubb KV, Lording PM. Cholesterol granuloma associated with otitis media and destruction of the tympanic bulla in a dog. Vet Pathol. 2007; 44 (4): 547-549.
7. Ziemer LS, Schwarz T, Sullivan M. Otolithiasis in three dogs. Vet Radiol Ultrasound. 2003; 44 (1): 28-31.
8. Sturges BK, et al. Clinical signs, magnetic resonance imaging features, and outcome after surgical and medical treatment of otogenic intracranial infection in 11 cats and 4 dogs.J Vet Intern Med. 2006; 20 (3): 648-656.
9. Rohleder JJ, et al. Comparative performance of radiography and computed tomography in the diagnosis of middle ear disease in 31 dogs. Vet Radiol Ultrasound. 2006; 47 (1): 45-52.
10. Trower ND, et al. Evaluation of the canine tympanic membrane by positive contrast ear canalography. Vet Rec. 1998; 142 (4): 78-81.
11. Palmeiro BS, et al. Evaluation of outcome of otitis media after lavage of the tympanic bulla and long-term antimicrobial drug treatment in dogs: 44 cases (1998-2002).J Am Vet Med Assoc. 2004; 225 (4): 548-553.
12. Stern-Bertholtz W, Sjostrom L, Hakanson NW. Primary secretory otitis media in the Cavalier King Charles Spaniel: a review of 61 cases. J Small Anim Pract. 2003; 44 (6): 253-256.
13. Corfield GS, et al. The method of application and short term results of tympanostomy tubes for the treatment of primary secretory otitis media in three Cavalier King Charles Spaniel dogs. Aust Vet J. 2008; 86 (3): 88-94.
14. Moriello, KA & Diesel, A (2010).

Eardrum ruptured. How long does it take for the eardrum to heal after rupture? Eardrum: structural and functional features

Perforation of the tympanic membrane, the treatment of which should be mandatory in most cases, causes both the middle and the inner ear to lose their original protection. This condition can be complicated by frequent inflammatory diseases.If you do not take care of the restoration of the barrier function of the membrane in a timely manner, the infection can deepen and spread through the intracranial space, provoking irreversible complications. If you have a hole in the ear membrane, only a doctor should understand how to treat this damage. Amateur performance in this case is inappropriate and even dangerous.




First aid

What to do if the eardrum bursts? The victim should be extremely careful in the first place.It is categorically impossible to engage in rinsing the ear, removing blood clots from the ear cavity, as well as drying it or cooling it by applying cold objects. First aid is reduced to placing a sterile ball of cotton wool or turunda (they must be dry) into the external ear canal, bandaging the ear and transporting a person to a nearby clinic or hospital.

If the pain syndrome is too severe, you can take diclofenac (1 tablet 0.05 grams) or paracetamol (0.5 grams).

When transporting the victim, you need to protect him from shaking. In addition, he should not be thrown back and tilted to any side of his head. And remember: if the eardrum has burst, treatment should be prescribed as soon as possible to avoid complications.

Treatment methods

In more than 50% of all cases of rupture of the tympanic membrane, no treatment is required. It is much faster and easier to heal gap-shaped ruptures that occupy less than 25% of the membrane area.So, if the eardrum in the ear burst in such a simple form, what should the victim do? He was prescribed complete rest, sharply limiting any manipulations in the external ear canal. In particular, it is forbidden to process it with cotton swabs and instill any drops. The last event can even be harmful. Indeed, through the hole formed as a result of the injury, the medicine in the drops will enter the middle ear and disrupt its structure.

If a foreign body gets in

Treatment of perforation of the tympanic membrane, if it is not complicated by any pathological process, does not require the intervention of a surgeon.First, the doctor removes a foreign body from the ear canal. Then he inserts an antiseptic swab made of cotton wool soaked in rubbing alcohol or hydrogen peroxide. Such a thorough treatment of the damaged area makes it possible to prevent infection from entering the auditory tube.

If damage to the membrane by a foreign body is complicated by an ear disease, it is treated according to the same method as for acute otitis media.

Myringoplasty

If, for example, there is a damage to the eardrum with a cotton swab, the treatment will be carried out operatively.This operation is called myringoplasty. In the process of such an intervention, the surgeon cuts out a small fragment of the fascia (connective tissue membrane) of the temporal muscle from the area above the patient’s ear. It will be needed in order to close the damaged section of the membrane with it.

After this manipulation, the doctor puts microinstruments into the external ear canal, the work of which is controlled by a special microscope. With these tools, the doctor slightly lifts the torn membrane, substitutes a pre-cut “patch” to the place of rupture and reliably sews it using threads that self-destruct over time.

After the completion of the surgery, the external ear canal is tamponed with a turunda with antibacterial impregnation. The patient is discharged with an ear bandage, which is allowed to be removed no earlier than after 7 days.

Sutures usually self-liquidate after about 2-3 weeks. This period is just enough to fully heal the wound. The hole in the eardrum, which has been successfully treated, will close completely. In the first couple of days of the postoperative period, minor ear pains and some discomfort are possible.

In order not to damage the membrane again, it is forbidden to sneeze, tightly closing your mouth, and take sudden breaths through your nose.

Ossiculoplasty

If there is a rupture of the tympanic membrane from a blow, treatment involves ossiculoplasty. This is the second stage after tympanoplasty (operations to restore the integrity of the membrane). Such surgical intervention is mainly aimed at the reconstruction of the damaged sound conduction system. The surgeon restores the ossicular chain with instruments, replacing the damaged areas with implants.

The operation is performed under local anesthesia. In the first few days of the postoperative period, the patient must strictly adhere to the prescribed bed rest. This is very important for proper healing.

Treatment with folk remedies

After the diagnosis “perforation of the tympanic membrane” established by the otolaryngologist, treatment with folk remedies is permissible. However, it is recommended that you always consult a doctor on this matter. After all, each case is individual, and the main thing is not to harm yourself.

If the victim is diagnosed with otitis media with perforation of the tympanic membrane, propolis treatment will be one of the most successful options. After the end of the course of such treatment, hearing acuity significantly increases, tinnitus decreases and even disappears altogether.

For treatment with propolis, use its 30-40% alcohol tincture, combined with vegetable (preferably olive) oil in a ratio of 1: 4. Alcohol-oil emulsion should be shaken well before each use.Turundas are impregnated with it and injected into the ear canals.

It is necessary to leave turundas in the ears for 36 hours for adults and for 10-12 hours for children over 5 years old. It is recommended to do this every time before bed. The course of treatment consists of 10 to 12 such procedures. A noticeable increase in hearing is usually noted in 4-6 procedures.

Important: propolis is capable of provoking allergic reactions in those who have a predisposition to allergies to bee products.

Recipes for impregnating ear swabs

What to do if the tympanic membrane is damaged, you have already visited the doctor and he gave the go-ahead for the use of alternative methods? Of course, tampons with special medicinal impregnations are needed.

To speed up membrane recovery, soak a sterile cotton swab with olive oil and place it in your ear, then cover it with a warm cloth and attach a cloth bag with pre-warmed bran on top. Additionally, it is recommended to ingest a rosehip infusion at room temperature or a decoction of low concentration medicinal chamomile flowers.

Before going to bed, you can put a cotton swab soaked in onion or calendula juice in your ear and leave it overnight.

As an alternative option for severe pain, you can use the leaves of fragrant pelargonium. Two or three of these leaves you need to wrinkle a little with your fingers so that they let the juice out, then wrap them in a sterile bandage and insert such tampons into the ear canal.

Summarizing

When the tympanic membrane is damaged, treatment should be started immediately. The prognosis is very favorable if your reaction to ear pain after an accidental injury is adequate and as fast as possible.In this case it is impossible to hesitate. It is recommended to immediately seek advice from a traumatologist or an otolaryngologist (your choice – to whom you will get access faster, go to that).

Minor injuries are characterized by the most favorable prognosis: more than half of all cases are self-healing with complete recovery of the victim.

If the injury turned out to be significant, then after healing, a scar forms at the site of the rupture and calcium salts are deposited.In this case, unfortunately, there is no hope for a complete recovery. Patients complain of a steady decline in the quality of hearing. The same not very favorable prognosis is characteristic of non-healing perforation.

If, as a result of an injury, not only the membrane, but also the ossicles is damaged, the so-called adhesive otitis media may develop, which also leads to hearing loss.

So, if your eardrum bursts, you already know what to do. The main thing is not to delay treatment and contact experienced specialists.

Rupture of the tympanic membrane occurs quite often in both children and adults. The membrane is the most fragile part of the human ear, therefore it is easily damaged due to various factors.
… Sometimes these factors are completely independent of human action. This pathological phenomenon leads to hearing impairment and the development of a serious inflammatory process in the ear cavity. This condition is very painful and gives a person a lot of discomfort. With the timely detection and elimination of the problem, hearing in almost all cases is restored without any consequences,

Reasons


The eardrum is a thin membrane that sits in the ear and separates the outer and middle ear cavities.It is impervious to water and air, and also prevents various foreign bodies from entering the ear. The function of the eardrum is to transmit sounds to the inner ear cavity.

The causes of damage to the membrane in children and adults are different. Most often, damage to this structure occurs due to such negative factors:

• Inflammatory process in the ear cavity. Quite often, with ear inflammation, which is accompanied by pain, people do not rush to the doctor. Due to this, exudate and pus gradually accumulate in the ear cavity, which not only exerts strong pressure on the membrane, but also corrodes it.If the disease is not treated for a long time, then after a while its rupture may occur.
• Increased pressure inside the ear cavity. Sneezing with a closed nose can lead to this. Particularly cultured people, trying to soften the sound of sneezing, cover their nose with their fingers, this leads to increased pressure inside the ear cavity. This situation occurs when an airplane takes off or a sharp dive under water.
• Extremely loud sound can also rupture the ear membrane. This often happens during an explosion, in which not only a loud sound is generated, but also an increase in air pressure.
• Injury. The reason for damage to the membrane can be hygiene procedures carried out with cotton swabs and other piercing objects. For example, some people like to use hairpins, matches, and knitting needles to remove wax from their ears, thereby increasing the risk of injury. In young children, injuries often occur during play, when they put various objects in their ears.
• Thermal impact. The eardrum can also burst if exposed to heat. This is common in fires and is also seen in people who work at elevated temperatures, such as metallurgists.
• Accidental ingestion of foreign objects in the ear can also cause inflammation and further damage to the membrane. This can also be the case if a piece of cotton wool got into the ear during hygiene procedures. In a small child, this condition may be the result of games.
• Traumatic brain injury can lead to rupture, especially in cases where a person’s temporal bone is damaged.

A person should be very careful with the organs of hearing.It must be remembered that the hearing aid is very delicate and sensitive, so it is very easy to injure it.

Clean the ear canals only with cotton filaments. Cotton swabs should only be used to clean the outer ear.

How to understand that the eardrum has burst


Damage to the tympanic membrane is always accompanied by severe pain
. Often, painful sensations are such that a person’s eyes darken and consciousness becomes cloudy.After a couple of hours, the pain begins to subside, but the victim is faced with other signs of damage.

The main symptoms of damage to the tympanic membrane in humans are the following pathological conditions:

• Hearing impairment. After a while, after the pain subsides, the person begins to understand that his hearing has become worse.
• Extraneous tinnitus. This pathological condition is observed when the membrane is damaged as soon as the pain subsides a little.The ringing immediately after the rupture of the eardrum becomes more and more pronounced, and it is not possible to eliminate it.
• Severe congestion in the ears occurs.
• If ​​the damage has also affected the auditory ossicles, a violation of the vestibular apparatus occurs. The person loses coordination and becomes distracted.

If the membrane bursts, then many victims note that when blowing out the nose, air seems to come out of the sore ear. This phenomenon is observed due to the structural features of the nasopharynx, where all ENT organs are directly connected.

In the event that a loud explosion is the cause of an injury to the auditory organ or the membrane is torn from a strong impact, blood begins to flow from the ear. This always indicates a more serious degree of tissue damage.

If you experience acute pain in one ear or two at once, you should immediately consult a doctor. It is impossible to delay contacting a specialist, as the inflammatory process will spread further and affect healthy tissues. If the inflammatory process spreads to the inner ear, then this is fraught with serious consequences.

The symptoms of a damaged eardrum will depend on what caused this pathology. Depending on this, the treatment regimen is also determined.

Diagnostics


If you suspect a damaged drum membrane, consult a doctor immediately. This problem is dealt with by an otolaryngologist or traumatologist, but if there are no such specialists in the clinic for some reason, you need to contact a therapist.

Not in all cases, the doctor can determine the damage only after a visual examination of the patient and palpation of the sore ear.Many patients after such traumas are in a state of shock, they cannot properly explain what exactly happened and how they feel. The integrity of the membrane is determined using a special instrument that carefully examines the auditory canal. The main purpose of such an examination is to determine the degree of damage to the membrane and the presence of pus or blood in the canal.

With the help of an otoscope, the doctor examines the inside of the ear, determines the degree of prevalence of the pathological process. After that, the consequences of such an injury are assessed.The doctor checks how much the patient’s hearing has decreased. To do this, they often resort to audiometry, which helps determine the level of hearing. Audiometry is performed only by an ENT doctor, it is impossible to check hearing in the traumatology department, since there is no special equipment there.

For an accurate diagnosis, it is necessary to take a number of tests from the patient. A clinical blood test allows you to determine how strong the inflammatory process is in the body. Analyzing the fluid flowing from the ear can help determine which pathogens are in the ear cavity.This allows you to prescribe medications as accurately as possible.

Only after a complete examination of the patient, the doctor makes an accurate diagnosis and prescribes the appropriate treatment.

Consequences


A ruptured eardrum can have serious consequences depending on how quickly the diagnosis is made and treatment is prescribed. The main problem is that the middle ear is not protected by anything and infections can easily enter the ear canal, provoking severe inflammation.Quite often, a labyrinthitis develops against the background of a damaged membrane. This disease is manifested by severe dizziness, nausea and vomiting. The patient’s coordination is impaired. In addition, otitis media and neuritis of the auditory nerve may develop, in which a person feels severe pain.

If treatment is not taken for a long time, the infection can spread to the lining of the brain. In this case, meningitis or encephalitis develops. Both of these diseases are quite dangerous and can be fatal.

In cases where the damage to the membrane is very extensive, surgery may be required. At the same time, it is highly likely that hearing will not be fully restored and the quality of human life will significantly deteriorate.

To avoid serious complications, you should see a doctor at the first sign of injury. This will allow you to start treatment in a timely manner.

Treatment details


If the injury is not very extensive, then the membrane heals on its own, after a while.For this to happen without any complications, the patient is advised to maintain complete rest and not clean the sore ear during the recovery phase.

If the eardrum has burst, the doctor may recommend a conservative and surgical method of treatment
… The choice depends on the degree of injury and the type of injury.

Conservative treatment

In case of minor damage, the doctor applies a special patch made of special tissue paper to the damaged membrane. It prevents germs from entering the middle ear cavity and speeds up recovery.You need to change such a patch every couple of days, the manipulation is carried out in compliance with the rules of antiseptics. In total, about 4 procedures are needed until complete recovery.

If there are blood clots and particles of pus in the ear cavity, the doctor carefully removes them with a cotton flagellum, and then treats the ear canal with medical alcohol. This is necessary in order to disinfect the wound and prevent the development of the inflammatory process. After processing the auditory canal, a dry cotton flagellum is inserted into it.

To avoid complications, the patient is prescribed broad-spectrum antibacterial drugs. They are especially necessary if more than a day has passed from the moment of injury to going to the doctor. Antibiotics are also needed when the victim has a fever.

Sometimes the doctor treats the edges of the wound with a solution of silver nitrate or chromic acid. In this case, the edges are only slightly wetted. It is strictly forbidden to bury such solutions in the ear!

Surgical method

If conservative treatment is ineffective or the rupture of the membrane is too large and looks intimidating, they resort to surgical intervention.Myringoplasty is performed in the following sequence:

• The operation is performed under general anesthesia, since the pain is quite severe, and even a person with a high pain threshold cannot bear it.
• Behind the patient’s ear, the doctor makes a small incision and takes a piece of skin, which is then used to repair the eardrum.
• After that, a piece of skin is carefully sewn to the membrane with special threads, which then dissolve themselves.
• After the operation is completed, cotton wool soaked in an antibiotic solution is placed in the ear canal.This is to prevent infection.

After the restoration of the eardrum, the patient needs to refrain from deep breaths and exhales through the nose for some time, as this can lead to displacement of the patch.

The prognosis after the operation is quite good. In many cases, hearing can be restored almost in full. The only exceptions are cases when a person asked for help too late, and the infection has affected too large areas of tissue.

Preventive measures


Any disease is always easier to prevent than to cure later. Therefore, you need to know the basic rules that will help prevent a ruptured eardrum.

• You cannot fly in airplanes and dive into the water at a time when any ENT diseases are aggravated.
• Do not clean the ear canals with hairpins or other sharp objects. You can use ear sticks only when cleaning the external auditory canal and auricle.
• It is necessary to start treating otitis media as soon as the first symptoms of the disease appear.
• Avoid loud noise. If the work activity is associated with increased noise, personal protective equipment should be used.
• When the plane is taking off, it is necessary to dissolve the lollipop or cover your ears with headphones.

It is strictly forbidden to self-medicate for pathologies of the auditory organs. Not all people know that many ear drops are prohibited during otitis media.A qualified doctor should prescribe treatment, otherwise the consequences can be unpredictable.

In case of damage to the tympanic membrane, the doctor prescribes a number of fortifying drugs that support the immune system and promote rapid recovery.

Traditional methods


Treatment can be supplemented with alternative methods. Such recipes have a tonic effect and accelerate recovery. To accelerate the regeneration of damaged tissues, you should consume more products rich in vitamin C.These include fresh vegetables and fruits, berries, and sauerkraut. In addition, the patient is advised to drink rosehip broth, grape juice and tea with the addition of hawthorn.

At the stage of recovery, a cotton turunda dipped in an infusion of nightshade or needles can be placed in the auditory canal
… All procedures must be agreed with the attending physician.

A ruptured eardrum should be treated as early as possible. Only in this case it is possible to avoid serious complications, which include labyrinthitis and meningitis.Treatment can be carried out both conservatively and surgically. Therapy is always complemented by the intake of antibacterial drugs.

Not everyone knows what a perforation of the eardrum is. If the tympanic membrane is damaged, a rupture occurs in it. This gap is called perforation. For this reason, the perception of sound changes, and the person develops hearing problems. Perforation of the membrane is dangerous because it can easily get an infection into the middle ear.It is very important to timely identify the pathology and start curing the perforation of the tympanic membrane. On this basis, many are wondering how to properly handle the ear during perforation and what drops can be used.

The root causes of the gap can be different. They are usually inflammatory or traumatic in nature. Mechanical injuries include:

• harsh sound;
  
• foreign body damage;
  
• puncture during ear cleaning;
  
• sudden pressure surges.

Foreign body injury is most common in children.

Inflammatory reasons include:

• otitis media of the middle ear;
  
• penetration of liquid into the ear;
  
• purulent otitis media;
  
• chronic inflammatory diseases of the organ.
  

Whatever the cause of the pathology, it is urgent to visit a doctor.

Symptoms


Immediately after damage to the tympanic septum, a person experiences severe pain.Symptoms of perforation of the tympanic membrane are:

• extraneous sounds in the ears;
  
• release of purulent mucus from the organ, if the impulse is due to otitis media;
  
• with perforation of the tympanic membrane due to trauma, bloody departments may appear;
  
• hearing impairment.
  

If the inner ear is injured, the patient becomes dizzy. If the eardrum is completely ruptured, then air comes out of the hearing organ.With minor injury, the signs are not pronounced. The severity depends on how damaged the organ is. With slight damage, the pain recedes quickly and hearing only slightly decreases. With extensive trauma, the inflammatory process can spread to the entire organ.

Complications


In case of perforation of the tympanic membrane, the symptoms of which may not be severe, it is important to start a timely cure. Otherwise, complications may arise. If the treatment of perforation of the tympanic membrane was not correct, then the consequences of a rupture of the tympanic membrane occur, which is dangerous to health.These include:

• unpleasant signs appear in the ear that has not been damaged;
  
• perforated otitis media;
  
• nerve neuritis;
  
• temporary memory loss;
  
• structural changes in some elements of the auricles;
  
• labyrinthitis;
  
• encephalitis;
  
• meningitis;
  
• separation of cerebrospinal fluid from the ears.

If the septum is ruptured, total hearing loss is possible.

Treatment


Only a doctor can answer how to treat a disease. Most often, drops are prescribed. Perforation of the tympanic membrane should be properly treated in a timely manner. Especially if the damage is observed in a child. If the tympanic membrane has undergone a rupture, it is necessary to return it to its normal appearance as soon as possible. First of all, if a hole appears in the eardrum, it is necessary to prevent infection from entering through it into the inner ear.To close the holes, you need to insert a cotton ball into the ear and apply a bandage.
For ear problems, only a doctor should cleanse. Cleaning is carried out only with sterile instruments. If after an injury in a patient, then in this case, analgesics are prescribed. Antiflogistic non-steroidal drugs are no less effective.

If the rupture is insignificant, the perforated membrane is restored without additional treatment.

Therapeutic methods


Therapeutic treatment is aimed at eliminating the inflammatory process.For this, doctors prescribe antibacterial drops. These include:

• Otipax;
  
• Tsipromed;
  
• Otofa et al.
  

The dosage and frequency of application of drops should be found out from the attending physician. The doctor prescribes them according to the manifested symptoms and the patient’s condition. Drops based on Ciprofloxacin
is indicated for use three times a day during the first week of treatment.

If the gap is small, then drops are not applied.The technician uses a special paper patch to close the gap. The edges of the hole are necessarily treated with a growth-stimulating drug, after which a patch is applied.
If an accumulation of blood clots is detected, they are removed with a cotton swab followed by alcohol treatment.
In the case of a small area of ​​the lesion, the specialists perform cauterization of the resulting wound. This is done with silver nitrate or chromic acid. These tools are used to treat the edges of the wound.
Experts recommend the use of mucolytic drugs that help thin mucus. After admission, the departments are promptly removed from the organ of hearing. To reduce puffiness and eliminate excess fluids, the intake of vasoconstrictor drugs in the nose is indicated. This allows you to reduce the pressure on the membrane and internal parts of the organ.
Antibiotic therapy is prescribed to avoid the spread of infection in the middle ear. When acute otitis media is detected, a full course of cure is carried out.This is necessary so that the acute form does not turn into chronic otitis media.

Surgical methods


If the therapeutic method did not give any improvement or the affected area is too extensive, then you cannot do without surgical intervention. Most often, with perforation of the tympanic membrane, treatment with medication has a positive effect. Elimination of the inflammatory process leads to self-healing of the membrane.
The surgical procedure to repair the septum is called myringoplasty.This intervention is performed under general anesthesia using an endoscope. It is embedded in the ear canal. A piece of skin is sewn to the membrane using self-absorbing threads. The stitched seams help hold the patch. The threads are absorbed within a few weeks. Ear care during this period consists in treating it with antibacterial drugs.
After surgery, a person may experience discomfort. In the early days, it is not recommended to breathe through your nose.This will help relieve excessive pressure on the repairing eardrum. Otherwise, a piece of skin will move to the side, disrupting the healing process.

Folk remedies


Often, traditional medicine recipes are used by patients for a speedy recovery. This method cannot replace the therapeutic one, but it is an excellent addition to traditional methods. To speed up the healing of the injury, it is necessary to eat more foods rich in ascorbic acid:

• citrus fruits;
  
• hawthorn;
  
• cranberry juice or fruit drink;
  
• rosehip decoction.

The use of sweet grapes will be useful. It is recommended to moisten a tampon for the ear canal with plantain juice or pine needles. It is also effective to moisten with tincture of nightshade leaves. To prepare it, you need 2 tablespoons of herbs to pour 0.5 liters of alcohol. Leave to infuse for 14 days.
The hole remains for a long period of time after healing. For this reason, the entire healing process must be kept under control. This will help to stop the deterioration of hearing and the transition of the disease into a chronic form.

Prevention


In order to protect yourself from damage to the membrane and from all possible complications, it is imperative to adhere to preventive measures:

1. Carefully and correctly cleanse the organ. It is especially important for parents to pay attention to hygiene procedures in children. In the case of cleaning an organ using sharp objects, injury may occur.
2. Do not listen to loud music. It is important to avoid noise.
3. Timely and competently take a course of treatment for diseases of the nasopharynx and ear.The most likely reason for the rupture of the septum is the untimely cure of inflammatory processes. With self-administration of drugs, otitis media may begin to progress and other consequences develop.
4. Protect the ear canals from liquid penetration. When taking a bath, it is recommended to use special caps that prevent the ingress of liquids. This relieves pressure on the inner ear.
5. Take action at the time of the flight. Use earplugs to regulate pressure.

From all that has been said, we can summarize that it is possible to avoid such a disease only if all preventive measures are followed. With a timely visit to a doctor, the disease can be treated very simply without complications.

Damage to the tympanic membrane
– injury to the tympanic membrane caused by mechanical, physical, thermal or chemical factors. Damage to the tympanic membrane is accompanied by pain and congestion in the ear, ear noise, hearing loss.The clinical severity of these manifestations depends on the strength of the traumatic factor and, accordingly, the degree of damage that has occurred. Damage to the tympanic membrane is diagnosed during otoscopy and microotoscopy; when a secondary infection is attached, bacterial culture of the discharge from the ear is required. Conservative treatment of damage to the tympanic membrane includes freeing the ear canal from foreign bodies and blood clots, treating it with ethyl alcohol, prophylactic antibiotic therapy, and treatment of infectious complications.Surgical treatment consists of myringoplasty or tympanoplasty.

General

The eardrum is located at the end of the ear canal and separates it from the tympanic cavity of the middle ear. It consists of 3 layers: the outer one, which is a continuation of the epidermis of the skin of the ear canal, the middle one, which consists of radial and circular fibrous fibers, and the inner one, which is the mucous membrane of the tympanic cavity.The eardrum performs a protective function, preventing air, water, foreign bodies and microorganisms from entering the middle ear. The second function of the eardrum is sound conduction. The vibrations of the tympanic membrane caused by sound waves are transmitted from it along the chain of the auditory ossicles to the sound-receiving apparatus of the inner ear. The severity of violations of the protective and sound-conducting functions in case of damage to the tympanic membrane depends on the nature and degree of its injury.

Damage to the tympanic membrane can lead to its total destruction, partial or complete rupture, disruption of the integrity of individual layers or elements of the membrane.Damage to the tympanic membrane, accompanied by a violation of its integrity, is considered infected and poses a danger in terms of the development of infectious complications: acute otitis media, chronic suppurative otitis media, labyrinthitis, mastoiditis, otomycosis, etc.

Causes of damage to the tympanic membrane

Mechanical damage to the tympanic membrane the membranes can be associated with an ear injury, a foreign body of the ear, unskilled attempts to remove a sulfur plug, the use of objects that are not intended for this purpose (hairpins, matches, paper clips, etc.) to clean the external auditory canal.P.). Damage to the tympanic membrane is possible with traumatic brain injury, accompanied by a fracture of the temporal bone pyramid and violation of the integrity of the tympanic cavity.

The physical factors that can lead to damage to the tympanic membrane, first of all, include a sharp drop in pressure inside the tympanic cavity and in the external auditory canal. Acoustic (barometric) damage to the tympanic membrane is possible when falling on the ear, hitting the auricle, sneezing violently with a closed nose, being in the explosion zone, diving or caisson work, testing in a pressure chamber, jumping into the water from great heights.Acoustic damage to the tympanic membrane occurs as a result of its excessive stretching, can have varying degrees of severity, accompanied by aerootitis and aerosinusitis. Ear barotrauma can cause structural damage to individual layers or elements of the tympanic membrane; lead to damage to the vessel passing in the membrane; provoke a complete rupture of the tympanic membrane.

Thermal damage to the tympanic membrane is usually accompanied by a burn of the auricle. It can be of a household and industrial nature (blacksmithing, pottery, metallurgical workshops).Chemical damage to the tympanic membrane occurs when corrosive chemicals (acids and alkalis) enter the ear canal. Often it leads to the complete destruction of the tympanic membrane and the ingress of a caustic substance into the tympanic cavity, and through it into the inner ear. Military damage to the eardrum is also distinguished, which includes shrapnel and bullet wounds.

Signs of damage to the tympanic membrane

The moment of damage to the tympanic membrane, as a rule, is accompanied by a sharp pain in the ear.Then the pain syndrome may subside and complaints of hearing loss (hearing loss), noise in the ear and a feeling of congestion in it come to the fore. If an injury to the tympanic membrane leads to its rupture, then patients may notice the release of air from the injured ear when blowing their nose or sneezing. A corresponding result can be obtained during the Valsalva test. However, its implementation is not recommended, due to the possibility of introducing infection through the auditory tube in the presence of such diseases of the nasopharynx as pharyngitis, rhinitis, laryngitis, sinusitis, chronic tonsillitis, eustachitis, tonsillitis, ozena or adenoids.

The severity of clinical manifestations directly depends on how severe damage to the tympanic membrane has taken place. Minor damage to the tympanic membrane, affecting only its outer layer or individual fibers of the middle layer, does not lead to a noticeable loss of hearing. It is characterized by rapid regression of pain and other symptoms. Extensive damage to the tympanic membrane can be accompanied by a fracture of the auditory ossicles, dislocation or rupture of their joints, injury to the internal muscles of the middle ear cavity.The most common are ruptures of the incus and hammer-anvil joints, fractures of the legs and base of the stapes. Disturbances in the ossicular chain lead to severe conductive hearing loss. A fracture of the base of the stapes is accompanied by intense tinnitus and mixed hearing loss; possible vestibular disorders and leakage of perilymph from the ear.

Diagnosis of damage to the tympanic membrane

Since damage to the tympanic membrane accompanies 90% of ear injuries, its primary diagnosis is often done by traumatologists.However, for a more qualified diagnosis and determination of the optimal treatment tactics, patients with damage to the tympanic membrane need to consult an otolaryngologist. The main and often sufficient method in diagnosing damage to the tympanic membrane is endoscopic examination: otoscopy and microotoscopy. According to indications, audiometry, threshold audiometry, tuning fork examination, acoustic impedance measurement, electrocochleography, stabilography, vestibulometry, caloric test are performed to assess the function of the auditory and vestibular apparatus.Damage to the tympanic membrane, complicated by secondary infection, is an indication for bacteriological examination of ear discharge.

Otoscopy for damage to the tympanic membrane

With minor trauma, otoscopy reveals only the injection of the vessels of the tympanic membrane. Significant damage can be visualized as subtotal defects, punctate and rounded perforations, slit ruptures, or complete destruction of the tympanic membrane. Tears and perforations of the tympanic membrane are characterized by irregular scalloped edges.Through the perforation formed in the membrane, in some cases, during otoscopy, it is possible to see the medial wall of the tympanic cavity and reveal mucosal hyperemia characteristic of a fresh injury. Sometimes otoscopy diagnoses a hematoma of the tympanic cavity formed as a result of damage to the tympanic membrane. With mechanical or acoustic damage, different severity of hemorrhage in the tympanic membrane, from individual petechiae to massive hemorrhages, can be observed.

Some time after the damage to the tympanic membrane was obtained, a control otoscopy is performed.It is aimed at assessing the reparative processes occurring in the tympanic membrane. Follow-up otoscopy may reveal scarring or permanent perforation. In some cases, a dense white formation is observed in the thickness of the tympanic membrane, due to the deposition of calcium salts in the rumen. Salt deposition can also be observed along the edge of the remaining perforation.

Treatment of damage to the tympanic membrane

Uncomplicated damage to the tympanic membrane does not require unnecessary intervention.Do not flush the ear canal or instill drops in the ear. If necessary, remove the foreign body from the ear. If there are blood clots, they are removed with a dry cotton swab. To prevent infection, the ear canal is treated with ethyl alcohol. If there is a danger of developing inflammatory complications of the middle ear, systemic antibiotics are prescribed. Damage to the tympanic membrane complicated by a secondary infection is treated according to the principles of otitis media.

In cases where, after the treatment of damage to the tympanic membrane, an opening remains in it, its closure by a surgical method is indicated. For this purpose, tympanoplasty and myringoplasty are performed. Chicken amnion, temporalis muscle fascia, meato-tympanic flap, etc. can be used as a material for closing the perforation. Recently, a method for closing perforation by transplanting cultured human allofibroblasts has been developed in otolaryngology.It is used if the perforation is more than 50% of the area of ​​the tympanic membrane and does not show signs of healing after 14 days from the moment of injury.

Forecast of damage to the tympanic membrane

The outcome of damage to the tympanic membrane depends on its size. In about 55% of patients, spontaneous repair of the tympanic membrane is noted. The best prognosis for self-healing has slit-like ruptures of the tympanic membrane, as well as perforations that occupy no more than 25% of its area.A slight damage to the tympanic membrane is overgrown without leaving any traces. Significant damage to the tympanic membrane is accompanied by scarring. Massive cicatricial changes and calcification of the tympanic membrane, as well as the presence of persistent residual perforation, are the reasons for the development of conductive hearing loss.

An unfavorable prognosis for hearing recovery has damage to the tympanic membrane, combined with damage to the auditory ossicles or accompanied by infection.In the first case, adhesive otitis media occurs in the tympanic cavity, in the second, various inflammatory complications. Such a complicated damage to the tympanic membrane leads to persistent conductive or mixed hearing loss, requiring operations to restore hearing or hearing aids with modern hearing aids.

Damage to the tympanic membrane
has become one of the most frequently diagnosed problems that prevails
mainly in childhood.The characteristic anomaly is accompanied by
the presence of an abnormal opening in the tympanic membrane or its rupture, causing
gradual hearing loss. Such an anomaly is dangerous to health, because after
the appeared passage into the auditory tube penetrates a pathogenic infection, microbes
and viruses. Accordingly, otitis media is rapidly progressing with all of its
potential complications.

The reasons for this pathological
there are many processes, but the main one is still mechanical damage
tympanic membrane.It can be combined with traumatic brain injury.
penetration of a foreign body into the ear canal, direct
trauma to the auricle, inept
attempts to extract the sulfur plug, as well as serious bone fractures
cranial box.

In addition, it is not excluded
thermal damage to the tympanic membrane caused by burns of all stages
characteristic organ. The trauma in this clinical picture can be as follows
household and industrial, and in the latter case, it is worth noting that such
diseases are more and more often diagnosed at industrial enterprises
various specializations.

Also, do not forget about
chemical damage to the tympanic membrane, which is observed if such toxic
chemicals like acids and alkalis. These products are chemical
industry entail the final destruction of the tympanic membrane
and extensive damage to the inner ear.

Acoustic damage related
with exposure to a loud sound or shock, and most often progresses during the period
fighting. This pathological condition can provoke
permanent rupture of the eardrum and lead to irreversible deafness.

But among physical factors,
causing damage to the tympanic membrane, a sharp
pressure drop in the tympanic space and the external auditory canal. Of this
can be achieved by falling on the ear, severe sneezing with a pinched nose, hitting
auricle, tests in a pressure chamber, mountaineering, as well as being in the zone
explosion action.

The risk group primarily includes
small children who tend to put various small objects in their ears,
which in the future can become the main cause of the characteristic anomaly.So
that now, knowing the etiology of damage to the tympanic membrane, the patient
knows what should be avoided in the future in order to maintain his own health.

How to treat a hole in the eardrum

Eardrum perforation – causes, symptoms and treatment

Perforation of the tympanic membrane occurs when a rupture occurs in it and an opening forms. The tympanic membrane is a funnel that is composed of thin skin that is separated from the middle ear canal.The eardrum plays an important role. When the eardrum is damaged, a hole appears in it, vibrations are disrupted in it, because of this, a person has hearing problems. The hole is also dangerous because an infection can get into it, which spreads to the middle ear, thus, there may be inflammation and a person develops otitis media.

Causes of perforation of the tympanic membrane

There are many reasons that lead to trauma to the eardrum, most often due to inflammation or trauma in the ear, noise injuries are also included here:

1.Due to inflammation in the middle ear, discharge begins to accumulate, most often it is purulent. Due to the small volume in the middle ear cavity, the outflow of secreted in the Eustachian tube may be impaired, because it begins to clog. The fluid that begins to accumulate in the middle ear can put very strong pressure on the eardrum. The eardrum may be susceptible to melting of pus, making it thin at first and may rupture.

Then the pus comes out of the ear.The membrane completely loses its protective function, does not protect the middle ear from the external environment.

2. Due to acoustic trauma or barotrauma, when fluid accumulates inside the eardrum, it ruptures. It must be remembered that strong pressure, which occurs externally, leads to its rupture. This can happen if you sharply put an open palm to your ear, it can also burst when the plane is climbing or changing pressure. Therefore, it is so important to equalize the pressure in the eardrum by dissolving the candy or opening the mouth, thus, when it is swallowed, air enters the Eustachian tubes into the middle ear.

3. Due to noise trauma, with a sudden sharp noise – explosion, perforation of the eardrum may occur. In addition to the fact that hearing is sharply reduced, there is noise in the ears, after a while the hearing may recover a little.

4. Due to foreign bodies, this often happens when a person does not use a stick correctly when cleaning his ears, thus, the eardrum is injured, then an infection is brought into the middle ear.

Who is at risk of tympanic membrane perforation?

1.If fluid accumulates in the middle ear.

2. When self-cleaning the ear from wax using hard objects – cotton wool, sticks.

3. From severe scratching of the ear when itching occurs inside the ear.

Symptoms of perforation of the tympanic membrane

The eardrum is torn very painfully, the following signs indicate it:

1. There is a sharp and sharp pain in the ear.

2. Purulent and transparent discharge can be observed from the ear, due to the fact that otitis media occurs.

3. In cases where perforation is due to ear trauma by a foreign body or noise, bloody discharge may appear.

4. If fluid breaks through the eardrum, the pain may suddenly disappear.

5. The appearance of noise in the ears.

What are the complications of tympanic membrane perforation?

It does not threaten the patient’s health, it can heal in a few weeks, but in some cases the following complications may occur:

1.A person loses hearing, this often happens for a while, until the ruptured membrane heals. Remember that if the gap is large, it heals much longer, because of this, a person loses hearing for a long time.

Also, the location of the gap, perforation, can also affect hearing loss. If a person has a severe head injury that can damage the structure in the middle or inner ear, the person will lose hearing indefinitely.

2.Re-infection of the middle ear – chronic otitis media, with extensive perforation and its rupture, the middle ear can be permanently infected again, because of this, the inflammation becomes chronic, a person can permanently lose hearing.

Diagnosis of perforation of the tympanic membrane

To diagnose membrane perforation, an otoscopy can be performed by inserting a metal or plastic funnel into the ear. Further, the auricle can be pulled down or up.

Using this method, you can align the course in the ear canal, at the end you will see the tympanic membrane.The ear canal is lightened, with perforation, the opening of the tympanic membrane is clearly visible. If it has ruptured, the ossicles are seen in the middle ear.

Also, in some cases, there is pus and blood. If the doctor sees pus, he must take it for analysis in order to identify the pathogen, to determine the effectiveness of antibiotic therapy.

Eardrum perforation treatment

Most often, perforation of the membrane can heal on its own without complication in a few weeks.If it does not heal, it is urgent to treat it:

1. Using a patch for the tympanic membrane, if there is a small gap, the doctor closes it with a patch of paper. Pre-treats the edges from the tear with a special growth preparation, then applies a paper patch. You need up to 4 such procedures.

2. Surgical intervention is necessary if the rupture or perforation of the membrane is large, if the above method is ineffective.

This operation is called myringoplasty or tympanoplasty.It is imperative that during this operation general anesthesia is needed, the surgeon makes a small incision above the ear, takes a small piece of skin from it, he needs it in order to sew a hole in the eardrum. Absorbent materials will be inserted on both sides, with the help of which the flap can be held until it is engrafted.

Pain may be present for some time after the operation, but it will go away over time.

So, with the help of the operation, you can prevent infection, get rid of tinnitus, and restore hearing.

What ear drops can be used for tympanic membrane perforation?

Most ear diseases are treated topically with special drops, but not all drugs can be used if the patient has a ruptured eardrum.

What causes can cause perforation? What ear drops can be used to treat the pathology of the organ of hearing with a ruptured eardrum?

Common causes of diaphragm rupture

Selection of ear drops for the treatment of ear against a ruptured eardrum should be performed only by an otolaryngologist. A specialist will assess the condition of the cavity behind the perforated membrane, determine the true cause of your discomfort and select drugs that will cope with the existing inflammatory process without harming the functionality of the hearing organ.

The reasons for rupture of the membrane separating the outer ear from the tympanic cavity can be:

• Barotrauma;
• acoustic trauma;
• Mechanical injury, for example, when cleaning the ears;
• temporal bone fracture;
• thermal damage in everyday life and at work;
• purulent otitis media.

In ordinary citizens, purulent otitis media most often becomes the cause of membrane rupture.

In this case, the gradual accumulation of exudate in the tympanic cavity leads to a strong and painful tension of the film. In the end, the tympanic membrane does not withstand the pathogenic effects and pressure of purulent masses and breaks through.

Signs of ruptured diaphragm

A ruptured eardrum can be identified by specific features.

If the membrane was perforated as a result of trauma (mechanical, baro- or acoustic), then patients experience sharp pain at the moment of violation of its integrity. If the tympanic membrane ruptures against the background of the accumulation of pus in the middle ear cavity, the symptoms will be slightly different. The excruciating sensations of pressure, pain and shooting in the ear end abruptly as soon as a hole appears in the membrane through which the exudate flows into the ear canal.

After perforation, patients have the following symptoms:

• Tinnitus may occur;
• due to loss of mobility of the tympanic membrane, the quality of hearing decreases;
• purulent masses (with otitis media) or bloody and bloody discharge (with the traumatic nature of membrane rupture) emanate from the auditory canal.

Any painful sensations in the organ of hearing, as well as the appearance of purulent or bloody discharge from the ear canal require examination by a specialist and the appointment of the therapy necessary for each case.

The presence of a perforation in the membrane not only negatively affects the quality of sound perception by patients, but the rupture of the membrane seems to open an entrance for infection into the middle ear. For the period of scarring of the connective tissue, you should take care of protecting the hearing organ from pathogenic bacteria and fungi – this is the purpose of ear drops that will be prescribed by the otolaryngologist.

Types of ear drops

Topical preparations will be selected by a specialist on the basis of what exactly provoked the rupture of the tympanic membrane.

Ear drops are:

1. Antibacterial. These drops in the ear with perforation are prescribed if bacteria are the cause of the development of a purulent form of otitis media. Also, this type of drugs is used for prophylactic purposes in order not to allow the pathogenic flora that has penetrated through the perforation to develop an inflammatory process in the tympanic cavity.
2. Pain relievers. Such drops eliminate painful symptoms accompanying injuries and inflammation.
3. Antifungal. Drops that fight the fungus are prescribed for mycoses and as a preventive measure against the background of antibacterial therapy.
4. Anti-inflammatory. This type of drug is used to relieve extensive inflammation against the background of trauma and purulent processes.
5. Antiseptic. Disinfecting drops are included in the complex therapy if it is necessary to sanitize the tympanic cavity.

What drugs are allowed for perforation?

Not all ear drops presented on drugstore shelves are approved for use on the background of perforation of the tympanic membrane. The composition of many of them is quite aggressive and can harm the delicate and delicate structure of the middle cavity and inner ear.

In order to select the correct ear drops for perforation of the tympanic membrane, you should consult the ENT. The doctor will prescribe the appropriate drugs for you that will successfully cope with all the problems in your hearing organ and at the same time will not harm the functionality of the damaged ear.

At the moment, pharmacists do not have a universal remedy for the treatment of ears with ruptured membranes. You may need to use several drugs, each of which will combat a specific problem.

Your doctor may prescribe the following approved ear drops for membrane perforation:

1. Otipax. These are anti-inflammatory steroid drops with lidocaine. They not only extinguish the activity of pathogenic flora and relieve swelling of the mucous membrane, but also have a good analgesic effect.But this drug does not have a mild effect, and is not always able to cope with severe inflammation. Also, its use will be useless in the fight against bacterial infection.
2. Otofa. These ear drops are also approved for the treatment of a perforated hearing organ. They are effective in combating severe inflammation, but they do not have an analgesic effect.
3. Sofradex. It is these drops that will be effective for bacterial purulent otitis media of the middle ear, but their composition is quite aggressive.If the substance gets into the inner ear, it can cause hearing impairment, so otolaryngologists try to prescribe this drug with caution against the background of perforation.
4. Candibiotic. These are complex drops that combine antifungal and antibacterial effects.
5. Amoxicillin. The most popular ENT antibitic is also produced in the form of ear drops. It is broad-spectrum and can fight most of the bacteria that cause ear inflammation.

Special features

Ear drops prescribed by an otolaryngologist should be used strictly according to the scheme prescribed by your doctor. These recommendations are especially relevant to the use of antibacterial drugs.

• Injecting funds into the ears should be strictly timed, observing the dosage and intervals indicated by the doctor;
• in case of unpleasant sensations or side effects, inform the attending otolaryngologist about this, if necessary, he will prescribe another drug for you;
• do not quit treatment immediately after symptom relief – antibacterial agents should be added to the end in accordance with the recommendations of the otolaryngologist;
• at the end of the course of treatment, even if there are no complaints, be sure to see a specialist – he will evaluate the results of therapy and the rate of scarring of the tympanic membrane.

Eardrum perforation: symptoms and treatment

If the tympanic membrane is damaged, a rupture forms, as a result of which the vibration of sound is disturbed, and the person experiences hearing problems. The danger of perforation or rupture is that infections open up access to the inside of the auditory organ.

It is important to detect the problem in time and start treatment before otitis media and other complications develop. We will talk about the features of the treatment of the disease in this article.

Causes of ear damage

Prerequisites for rupture of the tympanic membrane in a child and adults may be:

1. Inflammation in the middle ear. With it, the secreted fluid is collected in the form of pus. In the ear, the outflow of fluid is disturbed, it accumulates and presses on the membrane, subjecting it to destruction by pus. The membrane, gradually thinning, ruptures and is no longer a barrier between the external atmosphere and the middle ear.
2. Burst due to pressure. This can happen with a sudden immersion in water, when sneezing with a closed nose, during landing and takeoff of an aircraft.
3. Unexpected loud noises can cause partial hearing loss and membrane damage.
4. Injuries occur when cleaning the ear with a match, paper clip, needle and other thin pricks.
5. Thermal damage occurs in production or when exposed to hot liquids.
6. Use of a cotton swab may cause foreign objects to enter the ear.

Signs of perforation of the tympanic membrane

Acute sudden pain appears immediately after injury.It subsides after a while, but the patient complains of the following symptoms:

• tinnitus and vibration;
• clear or purulent fluid begins to flow from the ear;
• bloody or bloody discharge, if the rupture is the result of an injury;
• Partial hearing loss.

If the injury has caught the inner ear, then dizziness appears . With a complete rupture of the membrane, at the moment of blowing your nose or sneezing air can be released from the injured ear .

Symptoms depend on the degree of damage. Pain quickly resolves with minor injuries , slightly impairing hearing acuity. All symptoms of a perforated ear post-traumatic condition should be verified and verified.

Determine whether vibrates in the ear, whether there is discharge and other listed signs.

In case of severe damage, the process of inflammation of the tympanic membrane can spread to the entire inner ear. Due to the penetration of infections and the violation of the integrity of the membrane, complications can occur :

• otitis media.
• labyrinthitis.
• neuritis of the auditory nerve.

Encephalitis and meningitis develop when the virus enters deep tissues. If the membrane has ruptured completely, total hearing loss may occur .

Treatment methods

Basically, the rupture of the membrane heals itself within a few weeks after the injury without complications and does not require special treatment procedures. Perforation heals faster if it covers less than 20% of the membrane area.

The patient needs to limit procedures in the ear canal and adhere to rest.

Drug therapy

If the gap is small, doctors use a paper patch to close it. The edges of the hole are treated with a growth stimulating agent. About four such procedures are needed.

If an accumulation of dirt or blood clots is detected, the doctor removes them with cotton swabs and lubricates the walls of the passage with alcohol, and then puts a dry cotton ball in the ear.

A cauterization agent is used to close the perforation with small breaks. Also, these drugs are used to treat the edges of the injury. To avoid infection in the middle ear, your doctor will prescribe antibiotics. If acute otitis media is diagnosed, a comprehensive and complete course of treatment is carried out.

Surgical intervention

If the area of ​​the rupture is extensive or the medical method was ineffective, then surgical treatment is possible.

Under general anesthesia, a small incision is made to the patient under general anesthesia, a flap of skin is taken from there and used to suture a hole in the membrane.A flexible endoscope is used and inserted into the ear canal. A piece of skin is sewn to the membrane using a self-absorbable thread.

Stitches hold the patch until the injury heals. It takes several weeks to dissolve. A swab is placed in the ear canal, treated with an antibacterial agent.

The patient may experience discomfort and pain after the operation. At first, it is advisable not to inhale air sharply with the nose, in order to avoid pressure on the eardrum.

Folk remedies

Often, patients resort to folk remedies for treatment. This approach does not fully replace medicine, and it can be used only after consulting a doctor.

It is necessary to consume a lot of vitamin C to accelerate the healing of the perforation. Foods with more vitamin:

Sweet grapes should be eaten as a source of energy. You can moisten the ear turunda with the juice of pine needles, plantain.

After the symptoms disappear, a hole in the membrane remains for a long time.It is imperative to monitor the healing process to prevent the transition to chronic disease and hearing impairment.

Ear drops for membrane perforation

Ear medicine is being developed to relieve inflammation and accelerate healing. With perforation, drops are allowed, which include steroid anti-inflammatory drugs and antibiotics.

1. Otipax – drops containing lidocaine, they are used to relieve pain. The steroid in these drops has an anti-inflammatory effect on the membrane.For otitis media, using only these drops is not enough.
2. Otof – very effective remedy for membrane perforation. Otof has a wide spectrum of action, but is contraindicated for lactating and pregnant women, it is not a means to relieve pain.
3. Sofradex is a prescription drug. Neomycin, which is part of the drug, can provoke toxic effects on cells, getting into the inner ear.
4. Candibiotic – combines several antibiotics.Has antifungal effect, but often causes allergies, so be sure to carry out a sensitivity test before use.
5. Amoxicillin is a drug with antibacterial and bactericidal effect. Antibiotic treatment continues for at least a week.

Preventive measures

Follow the recommendations to avoid rupture of the membrane:

1. Do not use sharp or pointed objects to clean the ear canal.
2. Avoid excessive noise.
3. Suck on lollipop or wear ear protectors when landing and taking off.
4. During an exacerbation of diseases associated with allergies and ENT organs, do not fly on airplanes.
5. Treat otitis media early.

As you already understood, a damaged eardrum can heal itself and does not entail serious consequences. The main thing is to prevent the development of infections and diagnose the problem in time.

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