Tympanic Membrane Perforation Flashcards
What can cause perforation?
disease, trauma, medical care
What does spontaneous closure varies with?
size, location, pathologic conditions
What are traumatic causes of TM perforation?
insertion of objects in ear, concussion, head trauma, sudden negative pressure, barotrauma, iatrogenic
What are teh symptoms?
sudden sever pain, bleeding, hearin loss, tinnitus, vertigo, purulent otorrhea (24-48 hr after), whistling sound during sneezing and nose blowing
How do you dx?
otoscopy, blood obscuring the ear canal, irrigation and pneumatic otoscopy avoided
What is tx for acute trauma?
no specifc, keep dry, ABX and ear drops
How do you catagorize perforation?
size and location (give by percentage of ear drum affected)
What is important about central vs marginal perforation?
center grows better and closes better
marginal is very hard to heal
What is the tx for infection perf?
topical ABX drops
What do you say if its too small to do percentage?
pinpoint
What is tx for contaminated water perf?
prophylaxis w/ ABX eardrops
When do most perforations close and when do you do surgery?
within 2 mo, after that you do surgery
What is the surgery for TM perf??
tympanoplasty with paper patch
