Tympanic Membrane Perforation
The Tympanic Membrane The
tympanic membrane, or eardrum, is a thin
membrane that separates the ear canal and
the middle ear. It is made of partially
translucent tissue. When sound waves strike
the tympanic membrane, it vibrates and
begins the process of converting these waves
into impulses that the brain understands as
sound.
The eardrum is also an
important barrier in preventing outside
particles such as bacteria from entering the
middle ear. The eardrum may be perforated by
acoustic trauma such as puncture by a Q-tip,
bobby pin, a hot slag from welding, or from
an open-handed slap to the ear. It may also
be ruptured by barotrauma, which is
pressure-induced damage, such as in scuba
diving.
The most common cause of
rupture is from ear infections, however,
which can cause increased fluid and pressure
in the middle ear. Conversely, a perforation
of the tympanic membrane may lead to
infection because bacteria can enter through
the hole and infect the middle ear. Many
perforations due to acute infection will
heal spontaneously, in much the same manner
that a cut on an arm would heal.
Usually healing occurs
within one month. Perforations that result
from chronic infections, however, especially
when the membrane sustains damage, often do
not heal. Symptoms of a Perforated Eardrum
If the perforation is caused by a middle ear
infection (otitis media), there may be pain
and/or bloody drainage from the ear. Mild
hearing loss and tinnitus (ringing in the
ear) may also occur.
The severity of hearing
impairment and tinnitus depend on the size
and location of the perforation and also the
degree, if any, of disruption of the bones
in the middle ear. If the perforation is due
to a sudden trauma or explosion, the
symptoms usually improve in a few days. If
chronic infection continues, however,
hearing loss may be sustained and
significant. Preventing Infection While an
Eardrum is Perforated While the eardrum is
perforated, the middle ear is unprotected
and is vulnerable to infection from
contaminated water.
It is very important to
keep the ear dry while showering, bathing,
or swimming, in order to prevent water from
entering the middle ear.
Your physician will
recommend specific methods of protecting
your ear, such as the use of cotton balls
coverd with petroleum jelly, silicone
earplugs, showercaps, etc. Treating a
Perforated Tympanic Membrane If the
perforation is very small, it may close on
its own.
Hearing aids may be
recommended for patients with minor hearing
loss who do not have recurring infections
and who do not swim regularly.
For individuals who do
have hearing loss and recurrent ear
infections (at least three months) despite
the use of antibiotics or other therapies,
it may be necessary to close the hole with a
surgical procedure called tympanoplasty.