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{{SK}} Tympanic membrane perforation; eardrum - ruptured or perforated
{{SK}} Tympanic membrane perforation; eardrum - ruptured or perforated


==Overview==
==[[Perforated eardrum overview|Overview]]==
Rupture or perforation (hole) of the [[eardrum]] can occur in [[infection]], [[Physical trauma|trauma]] (e.g. by trying to clean the ear with sharp instruments), explosion or loud noise. Flying with a severe cold can also cause perforation due to changes in air pressure and blocked [[eustachian tube]]s resulting from the cold. This is especially true on landing.


Perforation of the eardrum leads to [[conductive hearing loss]].
==[[Perforated eardrum historical perspective|Historical Perspective]]==


The perforation may heal in a few weeks, or up to a few months. Some perforations require intervention - this may use a paper patch to promote healing (simple procedure in the office of an ear, nose and throat specialist), or surgery ([[tympanoplasty]]).
==[[Perforated eardrum pathophysiology|Pathophysiology]]==


Hearing is usually recovered fully, but chronic infection over a long period may lead to permanent hearing loss.
==[[Perforated eardrum causes|Causes]]==


==Causes==
==[[Perforated eardrum differential diagnosis|Differentiating Perforated Eardrum from other Diseases]]==
Ear infections may cause a ruptured eardrum, more often in children. The infection causes pus or fluid to build up behind the [[eardrum]]. As the pressure increases, the eardrum may break open (rupture).


Damage to the eardrum can also occur from:
==[[Perforated eardrum epidemiology and demographics|Epidemiology and Demographics]]==
*A very loud noise close to the ear, such as a gunshot
*A rapid change in ear pressure, which may occur when flying, scuba diving, or driving in the mountains
*Foreign objects in the ear
*Injury to the ear (such as a powerful slap or explosion)
*Inserting cotton-tipped swabs or small objects into the ear to clean them


==Natural History, Complications and Prognosis==
==[[Perforated eardrum risk factors|Risk Factors]]==
===Prognosis===
The opening in the [[eardrum]] usually heals by itself within 2 months. Any [[hearing loss]] is most often short-term.
Rarely, other problems may occur, such as:


*Long-term [[hearing loss]]
==[[Perforated eardrum natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
*Spread of infection to the bone behind the ear [[mastoiditis]]
*Long-term [[vertigo]] and [[dizziness]]


==Diagnosis==
==Diagnosis==
===Symptoms===
Ear [[pain]] may suddenly decrease right after the [[eardrum]] ruptures.
After the rupture, the patient may have:
*Drainage from the ear (drainage may be clear, [[pus]], or bloody)
*Ear noise/ buzzing
*[[Earache]] or ear discomfort
*[[Hearing loss]] in the involved ear (hearing loss may not be total)
*Weakness of the face, or [[dizziness]] (in more severe cases)
===Physical Examination===
====Ear Nose and Throat====
An otoscope or a microscope is used to look into the patients ears. If the [[eardrum]] is ruptured, an opening would be seen, and even the bones of the [[middle ear]] may be seen.
Sometimes it is hard to see the [[eardrum]] because of drainage (pus) from the ear.


{| align:left
[[Perforated eardrum history and symptoms|History and Symptoms ]] | [[ Perforated eardrum physical examination|Physical Examination]] | [[Perforated eardrum laboratory findings|Laboratory Findings]] | [[Perforated eardrum other imaging findings|Other Imaging Findings]] | [[Perforated eardrum other diagnostic studies|Other Diagnostic Studies]]
| [[Image:TYMPANIC PERFORATION LEFT LABELED.jpg|thumb|250px|Picture of a central left tympanic membrane perforation.]] || [[Image:TM Perforation Labeled 2 .jpg|thumb|250px|Picture of  left tympanic membrane perforation.]] || [[Image:TM perforation SQ 478 L.jpg|thumb|250px|Picture of right inferior tympanic membrane perforation.]]
|}


==Treatment==
==Treatment==
===Medical Therapy===
[[Perforated eardrum medical therapy|Medical Therapy]] | [[Perforated eardrum surgery |Surgery]] | [[Perforated eardrum primary prevention|Primary Prevention]] | [[Perforated eardrum secondary prevention|Secondary Prevention]] | [[Perforated eardrum cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Perforated eardrum future or investigational therapies|Future or Investigational Therapies]]
 
Putting warmth on the ear may help relieve discomfort.
 
Painkillers such as ibuprofen or acetaminophen may be used to relieve pain.
 
Antibiotics (oral or ear drops) may be used to prevent or treat an infection.
 
Keep the ear clean and dry while it is healing


Place cotton balls in the ear while showering or shampooing to prevent water from entering the ear.
==Case Studies==
Avoid swimming or putting your head underneath the water.
[[Perforated eardrum case study one|Case #1]]
 
Sometimes a patch may be placed over the [[eardrum]] to speed healing.
 
===Surgery===
Surgical repair of the eardrum [[tympanoplasty]] may be needed if the eardrum does not heal on its own.
 
==References==
{{reflist|2}}


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Latest revision as of 23:38, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Tympanic membrane perforation; eardrum - ruptured or perforated

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Perforated Eardrum from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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