TYMPANIC MEMBRANE PERFORATION
(HOLE IN THE EARDRUM)
The tympanic membrane is commonly referred to as the eardrum. A perforation in the tympanic membrane is often known as a ruptured or punctured eardrum.
Clinical photographs showing perforated ear drums.
CAUSES
TRAUMA
the eardrum caused by injury due to ear bud
Impact to the ear, perhaps from a slap or the insertion of a foreign object like a cotton bud or hair pin.
INFECTIONS
Severe middle ear infections can lead to pus build up behind the ear drum, the pressure of the pus causes the ear drum to rupture.
pus accumulation in the middle ear behind the ear drum.
BAROTRAUMA
Pressure changes, commonly experienced in air travel or diving.
ACOUSTIC TRAUMA
Exposure to extremely loud noises.
PREVIOUS SURGERIES
Ear surgeries can sometimes result in perforation.
SYMPTOMS
HEARING LOSS
The conductive hearing loss is due to poor conduction of sound through the tympanic membrane, it is often temporary but can be permanent.
left ear (Blue squares) due to hole in the ear drum
PAIN
The conductive hearing loss is due to poor conduction of sound through the tympanic membrane, it is often temporary but can be permanent.
Sharp, intense pain commonly occurs at the time of rupture, either due to trauma or as a sequelae of Acute otitis media.
EAR DISCHARGE
Fluid or pus may drain from the affected ear.
TINNITUS
A ringing or buzzing noise in the ear.
VERTIGO
Dizziness or imbalance may occur.
BLEEDING
Blood may also be present due to traumatic perforation.
DIAGNOSIS
Diagnosing a tympanic membrane perforation is a meticulous process that Dr Sandeep Uppal and his team at The ENT Clinic carry out with utmost care. Here are the typical steps involved:
INITIAL CONSULTATION
Patient History: The team starts by taking a detailed medical history, focusing on any incidents that could have led to the perforation, such as trauma or infections.
Symptom Review: Symptoms like pain, hearing loss, discharge, and bleeding are discussed to assess the severity and duration of the condition.
PHYSICAL EXAMINATION
Otoscopy
Using an otoscope, the team examines the ear canal and the eardrum to assess the size, location, and severity of the perforation.
Microscopic Examination
Dr Sandeep also uses the microscope to check for signs of infection, discharge, or other abnormalities in the ear.
SPECIALISED TESTS
Audiometry
A comprehensive hearing test is performed to evaluate the extent of hearing loss. This helps in understanding the impact of the perforation on auditory function.
Tympanometry
This test measures the movement of the eardrum and the air pressure in the middle ear, providing valuable information on the condition of the eardrum and middle ear.
CT Scan
In complex or severe cases, a computed tomography (CT) scan of the ear may be recommended to get a detailed view of the middle ear, mastoid, inner ear structures and any signs of complications.
Culture Test
If an infection is suspected, a sample of the ear discharge may be taken for culture to identify the causative bacteria or fungi.
Consultation and Treatment Planning
Dr Sandeep Uppal and his team will review all the findings and discuss them with the patient. Based on the diagnosis, an individualised treatment plan is then formulated, which is crucial for the effective management of tympanic membrane perforation.
TREATMENT
Observation
The approach of observation, often termed “watchful waiting,” is one of the initial treatment pathways. Many minor perforations of the tympanic membrane due to trauma or acute otitis media have the ability to heal spontaneously over time, typically within a few weeks. Observation allows for a more personalised treatment plan. If the perforation doesn’t heal naturally or worsens, more aggressive treatments like surgical closure can be employed later.
The decision to observe a tympanic membrane perforation is a measured one, rooted in both medical and practical considerations. During the observation period, patients are generally advised to keep the ear dry and to avoid inserting anything into the ear canal. Follow-up appointments are scheduled for re-evaluation, and treatment plans may be adjusted based on the healing progress and symptomatology.
Antibiotics
Antibiotic ear drops or systemic antibiotics may be employed to fight off infection.
Surgery
For severe cases, myringoplasty or tympanoplasty may be advised to graft tissue onto the perforation to repair it .
Audiological Support
Hearing aids may be used during the recovery period.
COMPLICATIONS OF UNTREATED PERFORATIONS
Failure to promptly address a perforated eardrum can result in complications such as:
CHRONIC OTITIS MEDIA
Persistent infection in the middle ear.
CHOLESTEATOMA FORMATION
Growth of a skin cyst in the middle ear.
PERMANENT HEARING LOSS
The longer the perforation remains untreated, the greater the risk of permanent hearing loss.
TINNITUS
Persistent ringing or buzzing in the ear may become chronic.
STEP TOWARDS HEALING EAR DRUM PERFORATIONS!
A hole in the ear drum can be a silent troublemaker, but it doesn’t have to stay that way. Dr Sandeep Uppal and the team at The ENT Clinic are your partners in patching things up.
With our deep understanding and personalized care plans, we’re all about fixing those tiny tears in a way that’s just right for you or your child.
Don’t ignore a perforated ear drum. Let Dr Sandeep and our experts take a look and tailor a treatment that’s music to your ears. Contact us at The ENT Clinic for care that brings harmony back to your hearing!
Act now by scheduling an appointment through our appointment scheduling page or connecting with us via WhatsApp.
