Ear drum, a thin membrane which separated the ear canal( outer ear) and the middle ear. The medical term for eardrum is tympanic membrane. The middle ear is connected to the nose by the Eustachian tube.
A perforated eardrum is a hole or rupture in the eardrum is often accompanied by decreased hearing and occasional discharge. Pain is usually not persistent.
The causes of perforated eardrum are usually from trauma or infection. A perforated eardrum can occur:
- If the ear is struck squarely with an open hand or slap ( Usually on the victim’s (L) ear if the assualtant is Right handed. Common in young women (L) ear by the husband or boy friend
- Infections
- In Accident with a skull fracture
- After a sudden explosion ( Craker/Bomb)
- If an object (such as a match stick) is pushed too far into the ear canal (Very Rare) As a result of hot slag (from welding) or acid entering the ear canal
- Middle ear infections may cause pain, hearing loss and spontaneous rupture (tear) of the eardrum resulting in a perforation. In this circumstance, there may be infected or bloody drainage from the ear. In medical terms, this is called otitis media with perforation
- Most eardrum perforations heal spontaneously within weeks after rupture, although some may not if it is they are couple of months or more old ( inadvent use of ear drops, oil, buds use without proper ENT specialist attention) . During the healing process the ear must be protected from water and trauma. Those eardrum perforations which do not heal on their own may require surgery
Usually, the larger the perforation, the greater the loss of hearing. The location of the hole (perforation) in the eardrum also effects the degree of hearing loss. If severe trauma (e.g. skull fracture) disrupts the bones in the middle ear which transmit sound or causes injury to the inner ear structures, the loss of hearing may be quite severe.
If the perforated eardrum is due to a sudden traumatic or explosive event, the loss of hearing can be great and ringing in the ear (tinnitus) may be severe ( due to associated nerve injury). In this case the hearing usually returns partially, and the ringing may or maynot diminishes in a few days. Chronic infection as a result of the perforation can cause major hearing loss.
Before attempting any correction of the perforation, a hearing test Audiogram) should be performed. The benefits of closing a perforation include prevention of water entering the ear while showering, bathing or swimming (which could cause ear infection), improved hearing, and diminished tinnitus. It also may prevent the development of cholesteatoma (skin cyst in the middle ear), which can cause chronic infection and destruction of ear structures – a very dangerous ear disease.
During a virus infection, the nose has poor resistance against bacterial infections, which explains why bacterial infections of the nose and sinuses so often follow a "cold." When the nasal mucus turns from watery clear to thick yellowish or green, it usually means that a bacterial infection has taken over and a ENT specialist to be consulted.
If the perforation is very small, ENT Doctor may choose to observe the perforation over time to see if it will close spontaneously.
There are a variety of surgical techniques, but all basically place tissue across the perforation allowing healing. The name of this procedure is called Myringoplsty tympanoplasty. Surgery is typically quite successful in closing the perforation permanently, and improving hearing. It is usually done on an inpatient basis.