[21] Tympanic Membrane Perforation Flashcards

1
Q

What is tympanic membrane perforation also called?

A

Perforated eardum

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2
Q

What is a tympanic membrane perforation?

A

A hole or tear that has developed in the ear drum

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3
Q

How does tympanic membrane perforation usually resolve?

A

Usually heals by itself even after multiple perforations

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4
Q

What does tympanic membrane perforation make the middle ear more susceptible to?

A

Infection

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5
Q

What can cause infection following perforation?

A

Passing of bacteria contaminated water into the middle ear

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6
Q

What are the possible causes of tympanic membrane perforation?

A
  • Otitis media
  • Trauma
  • Explosions or loud noises
  • Surgery
  • Barotrauma
  • Grommets (iatrogenic)
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7
Q

What is the prominent symptom in tympanic membrane perforation?

A

Temporary conductive hearing loss

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8
Q

What are some other common symptoms in tympanic membrane perforation?

A
  • Tinnitus
  • Otalgia
  • Mucus discharge
  • Nausea and vomiting
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9
Q

How can tympanic membrane perforation be diagnosed?

A

On otoscopy

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10
Q

What might small perforations require for detection?

A

Otomicroscopy

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11
Q

What should be performed on diagnosis of tympanic membrane perforation and before any repair attempts?

A

Audiometry

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12
Q

When is conservative management appropriate for tympanic membrane perforation?

A

If the perforation is asymptomatic

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13
Q

What does conservative management of tympanic membrane perforation involve?

A
  • Reassurance of healing usually within 6-8 weeks

- Water precautions

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14
Q

When may topical antibiotic drops be required for tympanic membrane perforation?

A

In patients with intermittent episodes of ear discharge in addition to water precautions

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15
Q

Why should care be taken with some topical antibiotic drops?

A

Some contain substance that are ototoxic with prolonged use

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16
Q

What antibiotics drops can be used for long periods in tympanic membrane perforation?

A

Ciprofloxacin

17
Q

When may surgery be required to close tympanic membrane perforation?

A

If there is recurrent discharge or if the patient wants surgery to enable them to swim

18
Q

What surgery is available for repair of tympanic membrane perforation?

A

Myringoplasty

19
Q

What does myringoplasty involve?

A

Placing a graft (e.g. temporalis fascia) under the ear drum remnant allowing the epithelium to re-grow and close the defect

20
Q

What are the complications of tympanic membrane perforation?

A
  • Otitis media
  • Cholesteatoma
  • Hearing loss (usually temporary)