What are the common causes of a ruptured eardrum. How can you recognize the symptoms of a perforated tympanic membrane. What treatment options are available for a ruptured eardrum. How long does it typically take for a ruptured eardrum to heal.

Understanding the Anatomy and Function of the Eardrum

The eardrum, also known as the tympanic membrane, is a thin, delicate structure that plays a crucial role in our hearing process. Located at the end of the ear canal, it separates the outer ear from the middle ear. This remarkable membrane serves two primary functions:

1. Sound transmission: It vibrates in response to sound waves, converting them into mechanical energy that is then transmitted to the inner ear.
2. Protection: It acts as a barrier, preventing foreign objects, bacteria, and water from entering the middle ear.

A ruptured eardrum occurs when this thin membrane tears or develops a hole. This condition can lead to various complications, including hearing loss and increased risk of middle ear infections. Understanding the structure and function of the eardrum is essential for recognizing the potential causes and consequences of a rupture.

Common Causes of Ruptured Eardrums

A ruptured eardrum can occur due to various factors. Identifying these causes is crucial for prevention and proper treatment. Here are some of the most common reasons for eardrum perforation:

• Ear infections: Pressure buildup from middle ear infections can cause the eardrum to rupture.
• Physical trauma: Insertion of foreign objects, such as cotton swabs or bobby pins, can puncture the eardrum.
• Barotrauma: Rapid changes in air pressure, often experienced during air travel or scuba diving, can damage the eardrum.
• Head injuries: A forceful impact to the head can lead to eardrum rupture.
• Acoustic trauma: Exposure to extremely loud noises or explosions can cause the eardrum to perforate.

Can chronic ear infections increase the risk of eardrum rupture? Yes, repeated ear infections can weaken the eardrum over time, making it more susceptible to perforation. It’s essential to treat ear infections promptly and follow proper ear care practices to minimize this risk.

Recognizing the Symptoms of a Ruptured Eardrum

Identifying the signs of a ruptured eardrum is crucial for seeking timely medical attention. While some individuals may not experience noticeable symptoms, others may encounter a range of indicators. Common symptoms include:

• Sudden sharp ear pain or an abrupt cessation of existing ear pain
• Drainage from the ear, which may be clear, bloody, or pus-like
• Tinnitus (ringing or buzzing in the ear)
• Partial or complete hearing loss in the affected ear
• Dizziness or a sense of imbalance
• Facial weakness on the side of the affected ear

Is it possible to have a ruptured eardrum without experiencing pain? Indeed, some individuals may not feel any pain when their eardrum ruptures. In fact, if the perforation occurs due to a chronic ear infection, the sudden release of pressure might even provide relief from previous discomfort.

Unusual Signs of a Perforated Eardrum

In addition to the more common symptoms, some people may experience unique signs that indicate a ruptured eardrum:

• A whistling sound when blowing your nose
• The sensation of air coming out of your ear
• Increased sensitivity to loud noises
• A feeling of fullness or pressure in the affected ear

If you notice any of these symptoms, it’s important to consult a healthcare professional for proper diagnosis and treatment.

Diagnostic Procedures for Ruptured Eardrums

When a ruptured eardrum is suspected, healthcare providers employ various diagnostic techniques to confirm the condition and assess its severity. The primary methods include:

1. Otoscopic examination: Using an otoscope, a device with a light and magnifying lens, the doctor can directly visualize the eardrum and look for signs of perforation.
2. Pneumatic otoscopy: This involves using a rubber bulb to gently puff air into the ear canal. A healthy eardrum will move in response to the air pressure, while a ruptured one will not.
3. Tympanometry: This test measures the eardrum’s response to slight changes in air pressure, helping to assess its condition and mobility.
4. Audiology testing: Comprehensive hearing tests can determine the extent of hearing loss caused by the rupture.

How accurate are these diagnostic methods? While otoscopic examination is generally reliable, factors such as excessive earwax or drainage can sometimes obscure the view. In such cases, combining multiple diagnostic approaches ensures a more accurate assessment.

Challenges in Diagnosing Ruptured Eardrums

Diagnosing a ruptured eardrum can sometimes be challenging due to various factors:

• Small perforations may be difficult to see during an otoscopic exam
• Excessive ear drainage or wax can obstruct the view of the eardrum
• The location of the perforation may affect its visibility
• Some ruptures may heal quickly, making detection challenging if there’s a delay in seeking medical attention

In cases where standard diagnostic methods are inconclusive, additional tests such as CT scans or MRI may be necessary to assess the extent of damage and rule out other conditions.

Treatment Options for Ruptured Eardrums

The treatment approach for a ruptured eardrum depends on various factors, including the cause, size of the perforation, and associated symptoms. In many cases, ruptured eardrums heal on their own within a few weeks to months. However, medical intervention may be necessary to prevent complications and promote healing.

Conservative Management

For minor perforations, conservative treatment is often sufficient:

• Keeping the ear dry: Avoiding water exposure by using earplugs during bathing or swimming
• Pain management: Over-the-counter pain relievers to alleviate discomfort
• Antibiotics: Prescribed if there’s a risk of infection or if an infection is present
• Watchful waiting: Regular follow-ups to monitor the healing process

How long does it typically take for a ruptured eardrum to heal with conservative treatment? Most small to medium-sized perforations heal within 6 to 8 weeks with proper care. However, larger ruptures may take several months to heal completely.

Surgical Interventions

In some cases, surgical repair may be necessary:

1. Patching: A paper patch is placed over the perforation to promote healing
2. Tympanoplasty: A surgical procedure to repair the eardrum using a graft
3. Myringoplasty: A specific type of tympanoplasty focusing on repairing the eardrum itself

Surgical interventions are typically considered when:

• The perforation is large and unlikely to heal on its own
• There’s persistent drainage or recurrent infections
• Hearing loss is significant and not improving
• The rupture has been present for an extended period

Complications and Long-Term Effects of Ruptured Eardrums

While many ruptured eardrums heal without significant issues, potential complications can arise if left untreated or in severe cases. Understanding these risks is crucial for proper management and follow-up care.

Potential Complications

• Middle ear infections (otitis media): The perforation can allow bacteria to enter the middle ear, leading to infections.
• Cholesteatoma: Abnormal skin growth in the middle ear that can occur with chronic perforations.
• Permanent hearing loss: In rare cases, especially with large or multiple perforations, hearing loss may be permanent.
• Tinnitus: Persistent ringing or buzzing in the ear that may continue even after the eardrum heals.
• Balance problems: Damage to the inner ear structures can lead to vertigo or dizziness.

Are there long-term effects on hearing after a ruptured eardrum heals? In most cases, hearing returns to normal once the eardrum has healed. However, if the rupture is severe or if complications occur, some degree of hearing loss may persist. Regular follow-ups with an audiologist can help monitor and address any ongoing hearing issues.

Factors Influencing Long-Term Outcomes

Several factors can affect the long-term prognosis of a ruptured eardrum:

• Size and location of the perforation
• Cause of the rupture (trauma vs. infection)
• Timeliness of treatment
• Presence of underlying ear conditions
• Overall health and immune status of the individual

Understanding these factors can help healthcare providers tailor treatment plans and provide more accurate prognoses for patients with ruptured eardrums.

Prevention Strategies for Eardrum Ruptures

While not all cases of ruptured eardrums are preventable, there are several measures individuals can take to reduce their risk:

1. Proper ear cleaning techniques: Avoid inserting objects into the ear canal, including cotton swabs.
2. Prompt treatment of ear infections: Seeking medical attention at the first signs of an ear infection can prevent pressure buildup.
3. Protection during air travel: Using special earplugs or chewing gum during takeoff and landing can help equalize ear pressure.
4. Hearing protection: Wearing earplugs or earmuffs in loud environments can prevent acoustic trauma.
5. Careful water activities: Using earplugs while swimming or diving can prevent water from entering the ear canal.

How effective are these preventive measures? While no strategy is foolproof, consistently following these guidelines can significantly reduce the risk of eardrum ruptures. It’s especially important for individuals with a history of ear problems or those frequently exposed to high-risk environments.

Special Considerations for At-Risk Groups

Certain groups may be at higher risk for eardrum ruptures and may require additional preventive measures:

• Children: Due to their anatomy and susceptibility to ear infections, children may need extra care and monitoring.
• Scuba divers: Proper equalization techniques and avoiding diving with congestion or ear infections are crucial.
• Individuals with chronic ear conditions: Those with recurrent ear infections or previous eardrum perforations should be especially vigilant.
• Musicians and industrial workers: Regular hearing check-ups and consistent use of hearing protection are essential for these high-risk occupations.

By understanding the risks and implementing appropriate preventive strategies, individuals can significantly reduce their chances of experiencing a ruptured eardrum.

Innovations in Eardrum Repair and Regeneration

As medical science advances, new techniques and technologies are emerging to improve the treatment of ruptured eardrums. These innovations aim to enhance healing, reduce recovery time, and improve long-term outcomes for patients.

Tissue Engineering Approaches

Researchers are exploring various tissue engineering techniques to create more effective eardrum grafts:

• 3D-printed scaffolds: Custom-designed structures that support the growth of new eardrum tissue.
• Stem cell therapies: Using stem cells to regenerate damaged eardrum tissue.
• Biocompatible materials: Development of new materials that closely mimic the properties of natural eardrum tissue.

How promising are these new approaches? While many of these techniques are still in the experimental stage, early results have been encouraging. Clinical trials are ongoing to assess their safety and efficacy in humans.

Minimally Invasive Surgical Techniques

Advancements in surgical technology are leading to less invasive repair methods:

1. Endoscopic tympanoplasty: Using small endoscopes for better visualization and precision during surgery.
2. Laser-assisted myringoplasty: Utilizing laser technology for more precise tissue manipulation.
3. Regenerative injections: Exploring the use of growth factors and other biological agents to stimulate natural healing.

These innovative approaches aim to reduce surgical trauma, improve cosmetic outcomes, and potentially shorten recovery times for patients undergoing eardrum repair procedures.

Future Directions in Eardrum Treatment

Looking ahead, several exciting areas of research may shape the future of eardrum treatment:

• Nanotechnology: Developing nanoscale materials and devices for targeted drug delivery and tissue repair.
• Gene therapy: Exploring genetic modifications to enhance the eardrum’s natural healing capabilities.
• Artificial intelligence: Using AI algorithms to optimize treatment plans and predict outcomes.
• Telemedicine advancements: Improving remote diagnosis and monitoring of eardrum conditions.

As these innovative approaches continue to develop, they hold the promise of more effective, personalized treatments for ruptured eardrums, potentially revolutionizing ear care in the coming years.

Ruptured Eardrum: Symptoms, Treatments, and Recovery

Written by Joseph Saling

Medically Reviewed by Poonam Sachdev on April 21, 2022

• What Is a Ruptured Eardrum?
• What Causes a Ruptured Eardrum?
• What Are the Symptoms of a Ruptured Eardrum?
• How Is a Ruptured Eardrum Diagnosed?
• How Is a Ruptured Eardrum Treated?
• How Can a Ruptured Eardrum Be Prevented
• More

A ruptured eardrum, like a clap of thunder, can happen suddenly. You may feel a sharp pain in your ear, or an earache that you’ve had for a while suddenly goes away. It’s also possible that you may not have any sign that your eardrum has ruptured.

A ruptured eardrum — also known as a perforated eardrum or a tympanic membrane perforation — can lead to complications such as middle ear infections and hearing loss. It may also require surgery to repair the damage to the eardrum. But typically, especially if you protect your ear, a ruptured eardrum will heal on its own without treatment within a couple of months.

A ruptured eardrum is a tear in the thin membrane that separates your outer ear from your inner ear. That membrane, known as the tympanic membrane, is made of tissue that resembles skin.

The eardrum serves two important functions in your ear. It senses vibrating sound waves and converts the vibration into nerve impulses that convey the sound to your brain. It also protects the middle ear from bacteria as well as water and foreign objects. Normally, the middle ear is sterile. But when the eardrum is ruptured, bacteria can get into the middle ear and cause an infection known as otitis media.

A number of things can cause the eardrum to rupture; one of the most common causes is an ear infection. When the middle ear is infected, pressure builds up and pushes against the eardrum. When the pressure gets too great, it can cause the eardrum to perforate. When that happens, you may suddenly notice that the pain and pressure you’ve felt from the infection suddenly stops and pus drains from the ear.

Another common cause of a ruptured eardrum is poking the eardrum with a foreign object, such as a cotton-tipped swab or a bobby pin that’s being used to clean wax out of the ear canal. Sometimes children can puncture their own eardrum by putting objects such as a stick or a small toy in their ear.

Some ruptured eardrums result from what’s known as barotrauma. This happens when the pressure inside the ear and the pressure outside the ear are not equal. That can happen, for example, when an airplane changes altitude, causing the air pressure in the cabin to drop or rise. The change in pressure is also a common problem for scuba divers.

A head injury or an ear slap can cause the eardrum to rupture. So can an acoustic trauma caused by a sudden loud noise, such as an explosion or a sudden blast of loud music. Learn more about how to prevent noise-induced hearing loss.

Some people don’t notice any symptoms of a ruptured eardrum. Others see their doctor only after several days of general discomfort in their ear and feeling that “something’s not quite right with the ear. ” Some people are surprised to hear air coming out their ear when they blow their nose. Forcefully blowing your nose causes air to rise up to fill the space in your middle ear. Normally this will cause the eardrum to balloon outward. But if there is a hole in the eardrum, air will rush out. Sometimes the sound is loud enough for other people to hear.

Other symptoms of a ruptured eardrum include:

• Sudden sharp ear pain or a sudden decrease in ear pain
• Drainage from the ear that may be bloody, clear, or resemble pus
• Ear noise or buzzing
• Hearing loss that may be partial or complete in the affected ear
• Episodic ear infections
• Facial weakness or dizziness

If you have any of the symptoms of a ruptured eardrum, the doctor will do an otoscopic exam. An otoscope is an instrument with a light that’s used to look inside the ear. In most cases, if there is a hole or tear in the eardrum, the doctor will be able to see it.

Sometimes there may be too much wax or drainage for the doctor to clearly see the eardrum. If this is the case, the doctor may clean the ear canal or prescribe eardrops for you to use to help clear it. Sometimes, the doctor uses a rubber bulb attached to the otoscope to blow a puff of air into the ear. If the eardrum is not ruptured, it will move when the air hits it. If it is ruptured, it won’t.

The doctor may also test your hearing to determine how much effect the ruptured eardrum has had on your hearing; they may use a tuning fork to test it. The doctor may also ask for an audiology test, which uses a series of tones you listen to with headphones to determine your level of hearing. Most hearing loss due to a ruptured eardrum is temporary. Normal hearing returns usually after the eardrum heals.

Typically, no specific treatment is needed for a ruptured eardrum; the vast majority of ruptured eardrums heal within three months. Your doctor may prescribe an antibiotic — either oral or in the form of eardrops — to prevent an ear infection or treat an existing infection. If the ruptured eardrum is causing you pain, the doctor may recommend using an over-the-counter pain medication such as acetaminophen or ibuprofen. Warmth may be applied also to relieve discomfort.

If the eardrum is slow to heal, you may be referred to an ear nose and throat doctor who may place a patch over the eardrum. In some cases, surgery may be needed to repair a ruptured eardrum. The surgery is usually done on an outpatient basis. During the procedure, which usually takes a couple of hours, the doctor will attach a piece of your own tissue to the eardrum to rebuild the eardrum. Surgery is most commonly used for large perforations, for perforations that involve the edges of the eardrum, or for ruptured eardrums caused by an ear infection.

While the eardrum heals, you’ll need to keep the ear dry. That means no swimming or diving until the doctor says the eardrum is healed. You’ll also need to use a shower cap or use water-repellent earplugs (like swimmer’s wear) in your outer ear when you shower to keep water out. Other precautions include:

• Not using medicine other than what’s prescribed by your doctor in your ear
• Taking all the medicine prescribed by the doctor
• Protecting the ear from cold air
• Avoiding blowing your nose while the ear heals

The two most important steps you can take to prevent a ruptured eardrum are to avoid putting any object into your ear — even to clean it — and to treat ear infections promptly. It’s also important to see a doctor to remove a foreign object in your ear rather than try to remove it yourself.

Top Picks

Ruptured Eardrum: Symptoms, Treatments, and Recovery

Written by Joseph Saling

Medically Reviewed by Poonam Sachdev on April 21, 2022

• What Is a Ruptured Eardrum?
• What Causes a Ruptured Eardrum?
• What Are the Symptoms of a Ruptured Eardrum?
• How Is a Ruptured Eardrum Diagnosed?
• How Is a Ruptured Eardrum Treated?
• How Can a Ruptured Eardrum Be Prevented
• More

A ruptured eardrum, like a clap of thunder, can happen suddenly. You may feel a sharp pain in your ear, or an earache that you’ve had for a while suddenly goes away. It’s also possible that you may not have any sign that your eardrum has ruptured.

A ruptured eardrum — also known as a perforated eardrum or a tympanic membrane perforation — can lead to complications such as middle ear infections and hearing loss. It may also require surgery to repair the damage to the eardrum. But typically, especially if you protect your ear, a ruptured eardrum will heal on its own without treatment within a couple of months.

A ruptured eardrum is a tear in the thin membrane that separates your outer ear from your inner ear. That membrane, known as the tympanic membrane, is made of tissue that resembles skin.

The eardrum serves two important functions in your ear. It senses vibrating sound waves and converts the vibration into nerve impulses that convey the sound to your brain. It also protects the middle ear from bacteria as well as water and foreign objects. Normally, the middle ear is sterile. But when the eardrum is ruptured, bacteria can get into the middle ear and cause an infection known as otitis media.

A number of things can cause the eardrum to rupture; one of the most common causes is an ear infection. When the middle ear is infected, pressure builds up and pushes against the eardrum. When the pressure gets too great, it can cause the eardrum to perforate. When that happens, you may suddenly notice that the pain and pressure you’ve felt from the infection suddenly stops and pus drains from the ear.

Another common cause of a ruptured eardrum is poking the eardrum with a foreign object, such as a cotton-tipped swab or a bobby pin that’s being used to clean wax out of the ear canal. Sometimes children can puncture their own eardrum by putting objects such as a stick or a small toy in their ear.

Some ruptured eardrums result from what’s known as barotrauma. This happens when the pressure inside the ear and the pressure outside the ear are not equal. That can happen, for example, when an airplane changes altitude, causing the air pressure in the cabin to drop or rise. The change in pressure is also a common problem for scuba divers.

A head injury or an ear slap can cause the eardrum to rupture. So can an acoustic trauma caused by a sudden loud noise, such as an explosion or a sudden blast of loud music. Learn more about how to prevent noise-induced hearing loss.

Some people don’t notice any symptoms of a ruptured eardrum. Others see their doctor only after several days of general discomfort in their ear and feeling that “something’s not quite right with the ear.” Some people are surprised to hear air coming out their ear when they blow their nose. Forcefully blowing your nose causes air to rise up to fill the space in your middle ear. Normally this will cause the eardrum to balloon outward. But if there is a hole in the eardrum, air will rush out. Sometimes the sound is loud enough for other people to hear.

Other symptoms of a ruptured eardrum include:

• Sudden sharp ear pain or a sudden decrease in ear pain
• Drainage from the ear that may be bloody, clear, or resemble pus
• Ear noise or buzzing
• Hearing loss that may be partial or complete in the affected ear
• Episodic ear infections
• Facial weakness or dizziness

If you have any of the symptoms of a ruptured eardrum, the doctor will do an otoscopic exam. An otoscope is an instrument with a light that’s used to look inside the ear. In most cases, if there is a hole or tear in the eardrum, the doctor will be able to see it.

Sometimes there may be too much wax or drainage for the doctor to clearly see the eardrum. If this is the case, the doctor may clean the ear canal or prescribe eardrops for you to use to help clear it. Sometimes, the doctor uses a rubber bulb attached to the otoscope to blow a puff of air into the ear. If the eardrum is not ruptured, it will move when the air hits it. If it is ruptured, it won’t.

The doctor may also test your hearing to determine how much effect the ruptured eardrum has had on your hearing; they may use a tuning fork to test it. The doctor may also ask for an audiology test, which uses a series of tones you listen to with headphones to determine your level of hearing. Most hearing loss due to a ruptured eardrum is temporary. Normal hearing returns usually after the eardrum heals.

Typically, no specific treatment is needed for a ruptured eardrum; the vast majority of ruptured eardrums heal within three months. Your doctor may prescribe an antibiotic — either oral or in the form of eardrops — to prevent an ear infection or treat an existing infection. If the ruptured eardrum is causing you pain, the doctor may recommend using an over-the-counter pain medication such as acetaminophen or ibuprofen. Warmth may be applied also to relieve discomfort.

If the eardrum is slow to heal, you may be referred to an ear nose and throat doctor who may place a patch over the eardrum. In some cases, surgery may be needed to repair a ruptured eardrum. The surgery is usually done on an outpatient basis. During the procedure, which usually takes a couple of hours, the doctor will attach a piece of your own tissue to the eardrum to rebuild the eardrum. Surgery is most commonly used for large perforations, for perforations that involve the edges of the eardrum, or for ruptured eardrums caused by an ear infection.

While the eardrum heals, you’ll need to keep the ear dry. That means no swimming or diving until the doctor says the eardrum is healed. You’ll also need to use a shower cap or use water-repellent earplugs (like swimmer’s wear) in your outer ear when you shower to keep water out. Other precautions include:

• Not using medicine other than what’s prescribed by your doctor in your ear
• Taking all the medicine prescribed by the doctor
• Protecting the ear from cold air
• Avoiding blowing your nose while the ear heals

The two most important steps you can take to prevent a ruptured eardrum are to avoid putting any object into your ear — even to clean it — and to treat ear infections promptly. It’s also important to see a doctor to remove a foreign object in your ear rather than try to remove it yourself.

Top Picks

INJURIES OF THE EARDYRUM | Centrum Słuchu i Mowy MEDINCUS

What causes eardrum damage?
The most common causes of damage to the eardrum are chronic inflammation of the middle ear or trauma (for example, barotrauma after an explosion, a blow to the ear, or damage to the eardrum when cleaning the ear with various objects that are not intended for this).

What types of damage to the eardrum exist?
There are different types of damage to the eardrum:

• perforation

• destruction of the tympanic membrane structure due to retraction, which is the result of long-term inflammatory processes that occur when the auditory tube is obstructed, the purpose of which is to equalize pressure on both sides of the tympanic membrane. In these cases, the tympanic membrane may remain continuous, but without elastic elements, it may overstretch and not perform its function. It can lie on the structures of the middle ear (for example, on the auditory ossicles) and adhere to them and sometimes destroy them.

Is eardrum damage dangerous?
Due to the possibility of complications, each damage to the eardrum should be under periodic supervision and appropriate treatment. Damage to the tympanic membrane in the form of a perforation located on the edge is more dangerous than in the central parts, since there is a possibility that the epidermis will grow into the tympanic cavity (cholesteatoma). This epidermis can cause destruction of ear structures with purulent inflammation, hearing loss and the possibility of serious complications. In each case, perforation of the tympanic membrane is the site of infection in the middle ear (you can not wet the ear). In case of damage to the tympanic membrane due to excessive retraction, destruction of the auditory ossicles (hearing loss), as well as the appearance of perforation and ingrowth of the epidermis into the middle ear is possible.

How is eardrum damage diagnosed?
Damage to the tympanic membrane (inflammation of the ear, trauma) can be preliminarily identified on the basis of a medical examination (inflammation of the ear with or without discharge, trauma). The diagnosis can be made after a precise examination using an otoscope. Video otoscopy (examination of the ear with a small camera) and a diagnostic microscope, which we use in daily practice, make it possible to identify even minor damage to the eardrum. An audiometric study is most often helpful in diagnosing hearing loss.

What causes hearing loss when the eardrum is damaged?
Damage to the eardrum disrupts the sound wave reaching the ear. Weak vibration of the damaged tympanic membrane causes weakening of the movement of the auditory ossicles associated with it, as a result of which the sound transmission to the inner ear deteriorates. All of the above is expressed in conductive hearing loss. If damage to the eardrum is combined with damage to the ossicular chain, then most often the degree of hearing loss is even more pronounced. In case of damage to the eardrum due to barotrauma, for example after an explosion, changes in the inner ear may occur, which affects the deterioration of the receiving system of the ear, which leads to perceptual hearing loss. It can also cause tinnitus and possible dizziness. If both types of hearing loss exist at the same time, then we are talking about a mixed type of hearing loss.

How can damage to the eardrum be treated?
In the case of a small central perforation without complications, the patient is prescribed observation for several months, since the tympanic membrane has the ability to regenerate, and there is often the possibility of fusion without medical intervention. When the perforation does not heal, complications can occur (eg, the edges of the perforation begin to curl up, which can lead to their ingrowth into the tympanic cavity). In cases of perforation at the edges and in cases of excessive retraction of the tympanic membrane, along with the onset of destruction of the auditory ossicles or ingrowth of the epidermis into the tympanic membrane, surgical treatment is prescribed.

What is myringoplasty and what is it based on?
Myringoplasty, i.e. the reconstruction of the tympanic membrane, is performed through the external auditory canal, so no scars are visible from the outside (it is possible to perform the operation using an incision behind the auricle, but this is rarely used). In many cases, an additional incision is needed to obtain material for the reconstruction. The material can be a perichondrium resembling a piece of polyethylene or a thin piece of cartilage from the auricle (about 1 cm incision in an almost imperceptible part of the auricle) or part of the fascia of the temporalis muscle (about 2 cm incision in the scalp). The above materials are the person’s own tissues, so they are completely safe and there is no risk of infection. The choice of appropriate materials depends on the condition of the ear and the results of the hearing test. Doctors often decide which materials to use during surgery. The tympanic membrane is reconstructed using material that takes root in the surrounding tissues. After the operation, a dressing remains in the ear, and the doctor puts stitches in the places of incisions. After the stitches are removed, when the wound heals, the scars are almost or completely invisible. The auditory and anatomical result of the operation can be seen only after the removal of the dressing (most often after a week).

What improvement in hearing can be expected after surgery?
Hearing improvement after surgery is possible only within the limits that were determined on the basis of hearing tests before the procedure (the maximum ear performance is determined by the so-called bone conduction curve presented on a tone audiogram). The purpose of the operation is to remove the so-called reserves of the cochlea, which is shown on the audiogram as a space between the curves of air and bone conduction. In most cases, after the operation, the cochlear reserve closes completely, that is, theoretically, the maximum possible improvement in hearing occurs. In some cases, some cochlear reserve may remain, even if the ear is healed and the patient has a good anatomical outcome of the operation. This depends on previous inflammatory changes in the tympanic membrane (eg, tympanosclerotic changes that adversely affect the conduction of sounds and cause the tympanic membrane to harden). In some patients, the purpose of the operation is not to improve hearing, but to protect the ear from infection that enters with water and earwax.

What type of anesthesia do doctors use during myringoplasty?
These surgeries are usually performed under general anesthesia (narcosis). It ensures the safety of the patient and the comfort of the surgeon. It is possible to use local anesthesia, but only in cases where local anesthesia for medical reasons is the only acceptable form. Patients need small doses of pain medication from time to time after surgery.

Are there complications after myringoplasty?
In medicine, it is not possible to guarantee the full effectiveness of therapy. Possible complications after surgery can be divided into general and surgical. The general ones are associated with infections, anesthesia, drugs, movement restrictions, comorbidities, etc. The doctor responsible for the safe course of anesthesia (anaesthesiologist) will ask you for more information to reduce the risk of these complications. In addition, it will be necessary to perform several additional studies, such as determining the blood group with the Rh factor, morphology and biochemical blood tests, blood clotting tests, urine tests, and others.
Otosurgical complications: profound hearing loss or complete deafness of the operated ear, damage to the facial nerve, which can cause damage to the muscles of the face of the operated side, damage to the tympanic string, signs of which are taste disorders in the tongue of the operated side, prolonged imbalance, the occurrence or intensification of tinnitus, perforation eardrum, no improvement in hearing. The above complications are very rare, and their number depends on the experience of the operating team.

How does the postoperative period look like?
The most difficult are the first hours after anesthesia. During the first day, dizziness and nausea sometimes appear, which are the result of anesthetics or actions near the middle ear. The hospital stay is usually one to several days after surgery. After the complete removal of the bandage from the ear (about 7 days after the operation), the patient may already feel an improvement in hearing, even if the eardrum is still healing. Control hearing tests are performed at different time intervals, but the objective result of the operation can be assessed 4 weeks after the operation.

What are the tips after myringoplasty?
In the early period after surgery, the patient should lead a cautious lifestyle and avoid infection (it is necessary to avoid contact with people who have respiratory tract infections). After removal of the dressing, immediate noise must be avoided. Within a month it is impossible to wet the operated ear. After the operation, it is recommended to undergo audiological control at intervals of 1, 3, 6, 12 months.

Otitis is the main cause of ear pain. Symptoms, possible complications and treatment of otitis.

Author

Mishchenko Natalya Sergeevna

Leading physician

ENT

Creation date: 2016.03.31

Cashback 1000 rub for all services for a visit in June
More
All promotions

Otitis is the general name for any inflammation localized in the ear. Our ear is a complex organ, the structure of which can be divided into three parts: the outer ear, including the auricle and auditory canal to the tympanic membrane, the middle ear (the cavity behind the tympanic membrane) and the inner ear. Accordingly, there are three types of otitis media: otitis externa , otitis media (or inflammation of the middle ear) and internal otitis ( labyrinthitis ) – a serious but rare disease. Doctors also talk about right-sided or left-sided otitis media – depending on which ear has inflammation. If the inflammatory process has affected both ears, the diagnosis is bilateral otitis media .

Otitis externa

Otitis externa is inflammation that can affect the pinna and/or ear canal. The path of infection can be opened, for example, by a wound caused by careless cleaning of the ears. The hair follicle or the mouth of the sebaceous gland may become inflamed – in this respect, the outer ear is no different from other areas of the skin.

If the inflammation is localized (for example, the hair follicle is inflamed), this form of the disease is called limited otitis externa . In this case, the pain in the ear first increases, then the abscess bursts, and the severity of the pain decreases. If the inflammation captures the entire ear canal, this form of the disease is called diffuse otitis externa . Diffuse otitis externa can be bacterial, fungal and allergic in nature.

The development of infection is facilitated by a humid environment. Moisture may linger in the ear canal after swimming; therefore, people who are actively involved in swimming experience otitis externa quite often, so that this disease has even been called “swimmer’s ear”. In hot weather, sweat can act as a moisturizer.

Sulfur plug can also provoke external otitis media. Under it, a favorable environment is created for the development of a fungal infection, and the patient’s attempts to remove the plug on their own lead to injury to the walls of the auditory canal, which facilitates the penetration of the infection.

More about otitis externa

Otitis media (otitis media)

Otitis media can develop as a complication of otitis externa, but much more often the infection in the middle ear comes from the nasopharynx through the Eustachian tube. In this case, otitis media is a complication of colds. It is enough to blow your nose incorrectly when you have a runny nose (without pinching one nostril), and discharge from the nose can get into the auditory tube. If this occurs against a background of weakened immunity, the development of otitis media is very likely.

The development of inflammation can contribute to the accumulation of fluid in the middle ear (exudate). This fluid is constantly being produced. Normally, it should leave the middle ear through the auditory (Eustachian) tube. This evacuation can be difficult due to diseases and pathologies of the nose (rhinitis, adenoids, deviated septum), as well as diseases of the auditory tube itself (eustacheitis, tubo-otitis). In this case, the fluid fills the space of the middle ear, becomes viscous, interferes with the work of the auditory ossicles. Such a state is defined as exudative otitis media . Infection of the accumulated fluid leads to the transition of exudative otitis into chronic suppurative otitis media.

Learn more about otitis media

Any questions?

Leave the phone –
and we will call you back

Otitis symptoms

The main symptom of otitis media is ear pain.

Pain in the ear

Pain in the ear with otitis can be severe, “shooting”.

Otitis media

Severe, “shooting” pain in the ear, characteristic of acute otitis media, usually leads us to immediately begin treatment of the disease. However, it is highly desirable that the treatment of otitis occurs under the guidance of a physician.

If two days have passed, and the ear is still bothering you, you must definitely see an ENT. There is a possibility that the disease can move to the next stage, in which purulent discharge begins to accumulate in the middle ear. The accumulated pus can rupture the eardrum. It is desirable to avoid this. If, nevertheless, pus must be removed from the tympanic cavity, then it is better that the doctor does this by making a neat puncture of the eardrum, the so-called paracentesis.

Left untreated, otitis media can become chronic. In this case, the pain in the ear ceases to be excruciating. For a long time, the patient may not feel pain at all. This is due to the fact that in chronic otitis the eardrum remains perforated, and through this hole pus can flow into the auditory canal without creating excessive pressure in the tympanic cavity. A permanent focus of inflammation and impaired integrity of the tympanic membrane contribute to the development of hearing loss.