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Tympanic Membrane Perforation

What is a tympanic membrane perforation?

Your tympanic membrane, or eardrum, is a stiff but movable oval membrane inside your ear. Your tympanic membrane separates your outer ear canal from your inner ear. A tympanic membrane perforation is a condition where your eardrum has a tear or hole in it.

What may cause a tympanic membrane perforation?

A tympanic membrane perforation may be caused by any of the following:

  • Changes in ear pressure: An increase or decrease in the pressure inside your ears may damage your eardrums. Changes in ear pressure may occur when traveling on an airplane, or if you are involved in an explosion. Underwater sports such as swimming or scuba diving may also cause pressure changes in your ears.

  • Direct trauma to your eardrum: Trauma may occur when small objects are placed inside your ear. Having the object removed may also cause damage to your eardrum.

  • Ear infection: Infections in your middle ear are called otitis media (OM). Otitis media can be a short-term infection, or become a chronic (recurring) infection. Ear infections may cause fluid or pus to collect behind your eardrum. The fluid and pus may cause pressure in your ear and cause your eardrum to tear.

  • Head trauma: Any event that causes impact to your head may also damage your eardrums. Contact sports, car accidents, and falls are common causes of head trauma that may lead to ear damage. A hard slap on your face or ear may also cause ear damage. Head traumas may cause a skull or facial fracture (break) in the bones near your ear. The sharp edge of a broken bone may puncture your ear and cause damage to your eardrum.

  • Past ear surgery or procedure: Past ear surgeries or procedures may cause further ear damage. Ask your caregiver for more information about surgeries or procedures that may have caused your tympanic membrane perforation.

What are the signs and symptoms of a tympanic membrane perforation?

You may have any of the following:

  • Clear, mucoid (phlegm-like), thick and yellowish, or bloody ear discharge.

  • Hearing loss in your involved ear.

  • Pain in your involved ear.

  • Tinnitus (ringing or buzzing sound in your ear).

  • Vertigo (dizziness).

How is a tympanic membrane perforation diagnosed?

Tell your caregiver about any past ear infections and ear treatments you have had. Your caregiver may ask if you have history of trauma, such as accidents or assaults. He may also ask if you are involved in any water or contact sports, or if you fly often. Your caregiver may use a special tool called an otoscope to look inside your ear. An otoscope will allow your caregiver to see your eardrum and the size and location of the tear. Your caregiver will also be able to see if there is fluid or infection inside your ear.

How is a tympanic membrane perforation treated?

A mild eardrum perforation may heal on its own over time. Your caregiver may clean your ear and put a bandage over it. He may also place a cotton ear plug in your ear to cover the tear. You may be given antibiotic medicine to treat or prevent infection caused by bacteria (germs). The medicine may be placed directly in your ear before it is covered with a bandage. Your eardrum may heal completely within a few weeks to a few months. You may also need the following:

  • Surgery: You may need surgery to repair your eardrum and prevent future ear infections. This is done when the hole in your eardrum is large, or does not heal on its own. You may also need surgery if your hearing loss or ear discharge does not get better with medicine. Ask your caregiver for more information on the following:

    • Myringoplasty: This type of surgery uses a tissue graft to cover your torn eardrum. A tissue graft may be taken from your own body, another person, an animal, or is man-made. A procedure called a mastoidectomy may also be done with a myringoplasty. A mastoidectomy is removal of infected bone from behind your ear. A mastoidectomy may also help prevent your eardrum from breaking down.

    • Tympanoplasty: This surgery repairs your torn eardrum and any damage to your inner ear. A tympanoplasty also helps prevent chronic ear infections. The hole in your eardrum will be covered with a tissue graft. You may also need to have a mastoidectomy with your tympanoplasty surgery.

What can I do to help myself?

  • Always keep your ear dry. Avoid getting your ear wet such as when bathing or swimming. Water that gets inside your ear may cause your damaged eardrum to heal slowly. Getting water in your ear may also increase your risk for infection. Ask your caregiver for ways to protect your ear from getting water in it.

  • Do not put anything in your ear. Never put pointed objects, such as a pencil in your ear. Pointed objects may damage or worsen the damage to your eardrum. A cotton ear bud placed deep inside your ear may also damage your eardrum. Ask your caregiver for information on how to clean your ears correctly.

  • Only use ear medicines as directed by your caregiver. If you have ear drop medicine, ask your caregiver when you need to stop using it. This type of medicine may cause more damage to your ear when used for a long period.

  • Try not to blow your nose. Blowing your nose may further damage your eardrum. Talk to your caregiver about medicines you can use if you have a cold or runny nose.

When should I call my caregiver?

Call your caregiver if:

  • You feel dizzy or are throwing up.

  • You have worsening ear pain or a new buzzing sound in your ear.

  • Your symptoms do not improve after taking medicine ordered by your caregiver.

  • You have questions about your condition, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • You are bleeding from your ear.

  • You cannot move or feel areas of your face.

  • Your hearing loss gets worse.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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