What Is a Tympanic Membrane Perforation?

The tympanic membrane, also known as the eardrum, is an oval translucent film composed of an epithelial layer, a fibrous layer, and a mucosal layer. It is located at the junction of the middle ear drum and the outer ear canal, and forms the outer wall of the ear drum. It separates the outer ear canal from the middle ear cavity. It also prevents foreign objects and bacteria that protect the external auditory canal from entering the middle ear cavity. During the process of auditory conduction, the structure of the eardrum can increase the gain of incoming sound waves and compensate for the attenuation caused by the sound.

Basic Information

nickname

Eardrum perforation

English name

tympanic membrane perforation

Visiting department

ENT

Common causes

Inflammation and trauma

Common symptoms

Severe ear pain, tinnitus, stuffy ears, hearing loss, etc.

Etiology of tympanic membrane perforation

Inflammation

Due to the anatomical characteristics of children, the eustachian tube connecting the nasal cavity and the middle ear cavity is short and thick. When the upper respiratory tract is infected, bacteria and secretions from the nasal cavity can easily reach the middle ear cavity through the eustachian tube and cause infection. When the posture is incorrect, milk and so on are also easy to flow into the middle ear through the eustachian tube and enter the middle ear, and acute otitis media results in perforation of the eardrum.

2. Trauma

It is mostly caused by direct or indirect external force injuries, such as ear cutting, surgery, foreign body in the external ear canal, temporal bone fractures, pressure injuries such as palm hitting the face, blasting, high diving and diving may damage the tympanic membrane, resulting in perforation of the tympanic membrane.

Clinical manifestations of tympanic membrane perforation

1. Perforation of the tympanic membrane caused by acute otitis media

The patient has ear pain first, which can be relieved after perforation of the eardrum, and fluid can flow out of the ear.

2. Tympanic membrane perforation caused by trauma

After the tympanic membrane ruptured, the patient developed ear pain, hearing loss immediately with tinnitus, a small amount of bleeding in the external auditory canal, and a feeling of bloating in the ear.

Tympanic membrane perforation

1. Perforation of the tympanic membrane caused by acute otitis media

The tympanic membrane is diffusely hyperemic and swollen, and the normal signs are difficult to identify. The pus can be seen at the perforation or the wave highlight (lighthouse sign). The hearing tests are mostly conductive deafness, and a few can be mixed and neurological deafness.

2. Tympanic membrane perforation caused by trauma

The tympanic membrane is usually irregular or fissure-like perforation, accompanied by congestion, blood stains, and hemorrhoids. If there is a large amount of bleeding or an outflow of water-like fluid, the possibility of cerebrospinal fluid ear leakage may be considered. Hearing tests are conductive or mixed deafness.

Tympanic membrane perforation

1. Perforation of the tympanic membrane caused by acute otitis media

Full body antibiotics should be used to control infection as early as possible, and drugs such as penicillin and cephalosporin can be selected. Local treatment: antibiotics can be used for ear fluid after washing the external auditory canal with 3% hydrogen peroxide. Perforation that cannot heal after inflammation control can be considered for surgical repair. Etiology treatment: Actively treat chronic inflammation of adjacent organs.

2. Tympanic membrane perforation caused by trauma

Remove foreign objects and blood clots remaining in the external ear canal. Avoid colds and don't blow your nose hard. The external ear canal is not allowed to be irrigated and medicined. Surgical repair may be considered for large or inability to heal perforations.