Tympanic membrane perforation after removal of tympanostomy ventilation tube Tympanic Membrane Perforation Definition A hole or tear in the eardrums Usually results from disease trauma or iatrogenic causes ID: 693901
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Slide1
Tympanic Membrane PerforationSlide2
Tympanic membrane perforation after removal of
tympanostomy
ventilation tube.
Tympanic Membrane PerforationSlide3
Definition
A hole or tear in the
eardrum(s
)
Usually results from disease, trauma, or iatrogenic causes
Infection is the major cause of tympanic membrane perforation (TMP)
Perforation can be temporary or permanent (most perforations heal completely on their own)
Symptoms of perforation varies with size and location on the ear drumSlide4
Signs and Symptoms
Ear pain that subside quickly
Otorrhea
Hearing loss
Tinnitus
Vertigo
Audible whistling sounds during sneezing and nose blowing
Frequent infection during colds or with water in the ear canalSlide5
Causes
Middle ear infection (most common)
Barotrauma
Acoustic trauma
Physical trauma to the tympanic membrane
Severe head trauma Slide6
Otoscopic
Appearance
http://sydneyentclinic.com/sean-flanagan/wp-content/uploads/2010/06/central_perforation.jpg
http://www.entbristol.co.uk/wp-content/uploads/2015/07/otoscopy_29.pngSlide7
Tympanic Membrane Perforation
Otoscopy Appearance
: Examination of right ear shows a clear canal leading to a perforated tympanic membrane. The drum is intact posteriorly up to the border of the malleus. Anterior (right of picture) to the malleus there is a large perforation extending from the superior to inferior borders of the annulus. The intact drum appears sclerotic. The middle ear is dry.
R6Slide8
Diagnosis
General
Clinical diagnosis with otoscopy examination
Otomicroscopy
can identify small perforation.
Middle ear impedance testing
Screening tympanometry may reveal abnormalities consistent
with perforation
Audiometry upon initial TMP diagnosis and before any
repair attempt
Imaging usually not indicatedSlide9
Treatment
Most traumatic TM perforations heal spontaneously
OK to watch and wait
Recommend dry ear precautions to prevent ear infection
Non-surgical in-office Treatments: eardrum paper patch
Surgery-
Tympanoplasty
(usually recommended after the age of 7)
2 reasons to do surgery:
Provide dry and safe ear
Restore hearingSlide10
Complications
Hearing loss
Otitis media
Cholesteatoma