Tympanic Membrane Perforation
What is a tympanic membrane perforation?
The tympanic membrane is the eardrum. The membrane separates the external ear from the middle ear and serves to amplify sound. A tympanic membrane perforation is a hole in the eardrum.
What are the signs and symptoms of a tympanic membrane perforation?
- Hearing loss
- Ear pain (otalgia)
- Drainage from the ear (otorrhea)
What causes a tympanic membrane perforation?
There are many possible causes of eardrum perforation. These include:
- Acute otitis media
- Direct trauma with foreign body
- Previous ear drum surgery (ear tube insertion)
- Eustachian tube dysfunction
- Chronic ear disease
How is a tympanic membrane perforation diagnosed?
Tympanic membrane perforation can be suspected with a history of ear trauma, ear tubes, frequent ear drainage or hearing loss. Hearing testing with testing of middle ear pressure (tympanogram) can raise the suspicion for a tympanic membrane perforation. Diagnosis requires an exam of the external and middle ear (otoscopy) which can be done with an otoscope or microscope.
How is a tympanic membrane perforation treated?
Many tympanic membrane perforations heal without any intervention and it is important to know that not all perforations need to be repaired. Dry ear precautions and antibiotic eardrops can be used to treat concurrent infection as the eardrum perforation heals.
Perforations that persist despite observation can be repaired in several different methods. The eardrum can be patched with a small graft (called a myringoplasty) or in some cases, a formal tympanoplasty or eardrum reconstruction is needed.
While many of these perforations can be repaired through the ear canal without any incisions around the ear, some require harvest of graft material from behind the ear and/or an approach from behind the ear to be able to adequately reconstruct the eardrum.