Tympanic Membrane Perforation

A tympanic membrane perforation, also known as a ruptured eardrum, is a tear or hole in the tympanic membrane, which is the thin layer of tissue that separates the outer ear canal from the middle ear.

Causes

• Middle ear infections: Bacterial or viral infections can cause the tympanic membrane to perforate.
• Trauma: A direct blow to the ear, a sudden loud noise, or an object inserted into the ear canal can cause a perforation.
• Eustachian tube dysfunction: The Eustachian tube connects the middle ear to the back of the throat and helps regulate air pressure in the ear. Dysfunction of this tube can lead to a perforation.
• Barotrauma: Sudden changes in air pressure, such as during scuba diving or air travel, can cause the tympanic membrane to rupture.

Symptoms

• Hearing loss: A perforated eardrum can cause a decrease in hearing ability, especially for low-frequency sounds.
• Ear pain: Pain or discomfort in the affected ear is common.
• Discharge: Fluid or pus may drain from the ear canal if there is an underlying infection.
• Tinnitus: Ringing or other noises in the ear can occur due to a perforated eardrum.
• Vertigo: Some individuals may experience dizziness or balance problems.

Diagnosis

A diagnosis of tympanic membrane perforation is typically made through a combination of:

• Otoscopy: A visual examination of the ear canal and eardrum using an otoscope.
• Tympanometry: A test that measures the movement of the eardrum and the reflexes of the middle ear muscles.
• Audiometry: A hearing test to assess the level of hearing loss.

Treatment

Treatment for a tympanic membrane perforation depends on the underlying cause and severity of the condition. Options may include:

• Antibiotics: To treat any underlying infections.
• Pain management: Medications to alleviate ear pain and discomfort.
• Ear drops: To help clear out any discharge or debris from the ear canal.
• Surgery: In some cases, surgical repair of the eardrum may be necessary, such as a tympanoplasty or myringoplasty.

Complications

If left untreated, a tympanic membrane perforation can lead to complications such as:

• Chronic ear infections: Repeated infections can cause ongoing damage to the middle ear and eardrum.
• Hearing loss: Permanent hearing loss can occur if the perforation is not properly treated.
• Middle ear damage: The bones in the middle ear (ossicles) can become damaged or eroded due to chronic infection or inflammation.