Tympanic Membrane Perforation

Tympanic membrane perforation, or perforation of the eardrum, occurs when the membrane is torn or punctured. Sometimes when the tympanic membrane is perforated, the small bones of the inner ear, called ossicles, are fractured at the same time. An eardrum perforation may cause hearing loss in the affected ear, but this is usually temporary.

Reasons for Tympanic Membrane Perforation

There are several reasons for eardrum perforation to occur. Among these are the following:

  • Fluid buildup behind the eardrum due to infection
  • Sudden changes in ear pressure, or barotrauma
  • Extremely loud noise as from an explosion
  • An object inserted into the ear
  • Injury, like a slap to the ear

Symptoms of Tympanic Membrane Perforation

Eardrum perforation is often a sudden occurrence, resulting in extreme pain in the ear. If the perforation is the result of a middle ear infection, however, the puncture may cause some relief from pain and result in a discharge of pus. Other symptoms of eardrum perforation may include:

  • Bleeding from the ear
  • Partial or total hearing loss in the affected ear
  • Buzzing or other noises in the ear
  • Facial weakness or dizziness

Diagnosis of Tympanic Membrane Perforation

Tympanic membrane perforation is diagnosed by a medical examination during which the doctor uses a small tube with a light, called an otoscope, to look inside the patient's ear. The doctor may also administer a hearing test to assess whether the patient has any hearing loss.

Treatment of Tympanic Membrane Perforation

Many times an eardrum perforation will heal on its own in a couple of months. During the healing period the patient may need to take over-the-counter or prescribed analgesics, either orally or as ear drops. It is also recommended that the affected ear be kept dry while the eardrum repairs itself because bacteria may grow in any accumulated fluid. Since there is now a hole in the tympanic membrane, the bacteria can penetrate the middle ear and cause an infection. Antibiotics may be prescribed prophylactically or if a bacterial infection is already present.

For rare cases when the eardrum does not heal within 2 months, surgery may be performed to repair the eardrum. There are two possible surgeries which may be performed: a myringoplasty or a tympanoplasty. The myringoplasty is a fairly simple operation to repair a small hole. The tympanoplasty is a somewhat more complex procedure to repair a larger perforation. A tympanoplasty requires a lengthier surgery and may include a repair of the fractured small bones of the inner ear.

Risks of Tympanic Membrane Perforation

When an eardrum perforation is suspected, the patient should always consult a medical professional. Untreated, this condition may lead to serious complications which may include an infection of the bone behind the ear called mastoiditis, vertigo, or even permanent hearing loss.

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