A hole in the
eardrum or a perforated tympanic
membrane (TM) is a common problem. A
hole in the eardrum disrupts the
conduction of sound into the inner ear
and produces a conductive hearing loss.
This hole also allows water and other
contaminants from the outside to infect
of irritate the delicate middle ear
membranes. This can produce infection
and drainage from the affected ear.
Trauma,
infection, and PE tubes are the most
common causes of tympanic membrane
perforations. Trauma can be from either
blunt causes (like being slapped across
the ear)
or
by penetrating causes (like a bobby pin,
pencil, or gun shot wound).
Fortunately, many traumatic perforations
will close spontaneously over 3 to 4
weeks. Keeping the ear dry and free of
infection helps in the healing process.
Some physicians prescribe antibiotic
eardrops to try to help the healing
process. Other physicians use a paper
patch to help seal off the middle ear,
improve hearing and aid in closure of
the perforation.
PET placement
is associated with persistent
perforation somewhere between 3 and 5%
of cases. This greatly depends on the
type of tube that is placed and the
reason for placement.
Chronic middle
ear Infection is probably the most
common cause of persistent TM
perforation. Most of these patients
have an underlying problem with
Eustachian tube function. Conditions
that worsen Eustachian tube function,
like allergic rhinitis and sinusitis,
are associated with chronic middle ear
infections in some patients.
Controlling these underlying conditions
can help to reduce the risk of middle
ear infections. However, despite
medical advances, very few medications
have been shown to improve Eustachian
tube function.
Please see our
webpage on
tympanoplasty
to learn more about the repair of TM
perforations.
