Germán Sandoval, M.D.

Otorhinolaryngologist Surgeon

A perforated tympanum consists on a rupture of the tympanum membrane. Tympanum separates external and middle ears, and vibrates when hit by sound waves; starting a process to turn sound waves into nervous impulses that reach the brain. Any damage in the tympanum structure interrupts the whole auditory process. 

Tympanum is also a barrier that prevents external substances to enter the middle ear (Bacteria, etc.). When tympanum is perforated, bacteria cross easily and reach the middle ear, causing an infection. 

Causes, development and risk factors:

Traumas, due to direct injury or to an injury caused by a sudden and exaggerated change in pressure usually damage the tympanum structure. Attempts to clean ears with cotton sticks or any little object are very dangerous and usually cause a tympanum perforation. 

Ear infections may produce a tympanum rupture, due to presence of liquids inside the middle ear, which increases internal pressure that could break the tympanum membrane.

A rupture in the tympanum frequently causes ear infections, due to the easy crossing of bacteria toward the middle ear. 

An otorhinolaryngologist must find all details and do a diagnosis, when a tympanum gets perforated. A diagnostic videoendoscopy allows a precise observation, including a sight of the middle ear little bones, an analysis of the mucosa cover. If there is also an infection, (chronic or acute otitis), doctors will see any secretion very easily, or see an ear drainage, pus. An audiometry test evaluates the amount of hearing loss. 

Treatment: 

A recently perforated tympanum could recover by itself in two or three months. In this case, if perforation is small and there is no infection or any other major problem, the initial treatment consists only on keeping ears dry and clean, preventing an infection. Antibiotics may be used, only if there is already an infection. With a microscope, doctors must explore and evacuate contaminated secretions inside the ear and put some otic solutions inside the ear. These substances are usually prepared by the otorhinolaryngologist, according to any particular case, to doctor’s personal experience and to scientific studies that back them up. 

Ear protectors, custom made, and adjusted elastic stripes are indicated to allow patients to go to beaches and pools. 

Tympanoplasty is a surgical procedure that corrects and closes defects in the tympanum membrane. It is carried out by using tissues from the patient himself. It restores the auditory mechanism that conducts sound to the brain. 

These situations require immediate help by an otorhinolaryngologist:

If this problem is diagnosed, and symptoms go on for more than two months, in spite of the medical treatment.

If a perforated tympanum is diagnosed, detecting drainage, accompanied by persistent fever, vertigo, buzzes and hearing loss in general.

Prevention:

Never introduce objects in the auditory channel, not even to clean it. Any strange object inside the ear must be extracted only by a physician. Traumas that involve ears or zones near them, require doctors’ exams to discard or not a tympanum perforation. Ear infections require immediate treatment. Always avoid improvisations, your ear does not forgive errors….

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