[21] Tympanic Membrane Perforation Flashcards
What is tympanic membrane perforation also called?
Perforated eardum
What is a tympanic membrane perforation?
A hole or tear that has developed in the ear drum
How does tympanic membrane perforation usually resolve?
Usually heals by itself even after multiple perforations
What does tympanic membrane perforation make the middle ear more susceptible to?
Infection
What can cause infection following perforation?
Passing of bacteria contaminated water into the middle ear
What are the possible causes of tympanic membrane perforation?
- Otitis media
- Trauma
- Explosions or loud noises
- Surgery
- Barotrauma
- Grommets (iatrogenic)
What is the prominent symptom in tympanic membrane perforation?
Temporary conductive hearing loss
What are some other common symptoms in tympanic membrane perforation?
- Tinnitus
- Otalgia
- Mucus discharge
- Nausea and vomiting
How can tympanic membrane perforation be diagnosed?
On otoscopy
What might small perforations require for detection?
Otomicroscopy
What should be performed on diagnosis of tympanic membrane perforation and before any repair attempts?
Audiometry
When is conservative management appropriate for tympanic membrane perforation?
If the perforation is asymptomatic
What does conservative management of tympanic membrane perforation involve?
- Reassurance of healing usually within 6-8 weeks
- Water precautions
When may topical antibiotic drops be required for tympanic membrane perforation?
In patients with intermittent episodes of ear discharge in addition to water precautions
Why should care be taken with some topical antibiotic drops?
Some contain substance that are ototoxic with prolonged use
What antibiotics drops can be used for long periods in tympanic membrane perforation?
Ciprofloxacin
When may surgery be required to close tympanic membrane perforation?
If there is recurrent discharge or if the patient wants surgery to enable them to swim
What surgery is available for repair of tympanic membrane perforation?
Myringoplasty
What does myringoplasty involve?
Placing a graft (e.g. temporalis fascia) under the ear drum remnant allowing the epithelium to re-grow and close the defect
What are the complications of tympanic membrane perforation?
- Otitis media
- Cholesteatoma
- Hearing loss (usually temporary)
