They put a membrane when hearing appears. What is dangerous damage to the eardrum and the possible consequences for hearing. Symptoms of damage to the eardrum

Perforation of the eardrum, the symptoms of which are usually quite pronounced, cannot go unnoticed. At the very least, there will be serious discomfort. However, not everyone associates pain with the appearance of a hole in the membrane.

How do you know if the eardrum is damaged? First of all, you need to visit an otolaryngologist. An experienced doctor will determine the degree of complexity of the injury and its cause, after which he will prescribe drugs for the regeneration of damaged tissue or suggest surgery.

What Happens During an Injury

When an object that injures it gets into the ear, the integrity of the membrane can be completely broken or any of its individual fragments. If the impact was weak, the victim will get off only with a plethora of membrane vessels. If it turned out to be more powerful, there is a rupture of blood vessels and hemorrhage in the tissue of the membrane. These symptoms of damage, visible with the help of special instruments, can be easily noticed by an experienced doctor. With maximum injury to the membrane, it breaks entirely, as a result of which the external ear canal receives direct communication with the tympanic cavity.

When wounded by a firearm, the symptoms of perforation are most pronounced. After all, it is accompanied by a violation of the structure of the tissues that surround it. This significantly increases the pain syndrome.

If a chemical burn occurs, most often only lumps remain from the membrane. In the absence of a barrier, toxins penetrate into the deep sections of the ear, destroying their structure. Signs of damage to the eardrum in adults in this case are reduced mainly to severe pain and persistent hearing problems.

Symptoms

Signs of perforation and their severity is directly dependent on the degree of damage to the membrane. An insignificant injury, which leads to a violation of only its outer layer or individual fibers of the middle layer, as a rule, is not accompanied by a noticeable hearing loss. Such damage, the signs of which are characterized by a fairly rapid attenuation of pain and a number of other symptoms, is considered the most uncomplicated.

Otolaryngologists note symptoms typical of a traumatic membrane rupture. So, how to understand that the eardrum has burst due to mechanical damage to it? You will definitely feel:

severe pain in the injured ear;
tinnitus;
discharge with blood from the auricle;
dizziness;
sudden decrease in hearing acuity (incomplete hearing loss).

In clinical practice, it has been recorded that the place where the tympanic membrane has ruptured (the symptoms are listed above) determines the percentage of hearing loss and possible complications. Thus, when the hole is closer to the edges of the membrane, the person suffers from conductive hearing problems - a decrease in audibility due to poor propagation of sound waves.

But the sound injury of the tympanic membrane, the symptoms of which are associated with lifelong hearing loss of the neurosensory type, suggests the presence of functional disorders in the receptors of the analyzer, which is located in the inner ear.

With regard to injury to the membrane of inflammatory origin, otolaryngologists call the following symptoms of rupture:

watery exudate released from the auricle;
otorrhea (a condition in which pus comes out of the ear);
a rapid decrease in the intensity of the pain syndrome;
tinnitus;
constantly developing decrease in hearing acuity.

With a serious traumatic brain injury, signs of damage to the membrane are expressed by ear liquorrhea - this is the name of the condition in which cerebrospinal fluid flows from the ear canal (this is the name of cerebrospinal fluid).

Diagnostics

How to understand if the eardrum is damaged? To diagnose such a problem, first of all, an otoscopy is performed. For this purpose, the doctor inserts a special funnel made of plastic or metal into the ear hole - an otoscope. The ear is then retracted either upward or downward.

This method allows you to make the course in the ear opening more even - so that a membrane appears at its end. The ear canal is clarified to see details. If a rupture or crack has indeed occurred, the doctor will clearly see a hole in the membrane. If it is completely torn, the auditory ossicles can be easily observed in the middle ear area.

In addition, in some cases, if the eardrum is damaged, the symptoms are reduced to the discharge of pus and blood from the auricle. If the doctor notices purulent discharge, he will take a sample of them for analysis in order to identify the pathogen as soon as possible and, accordingly, begin effective antibiotic therapy.

Possible complications

It should be noted that problems after ear surgery are very rare. Complicated perforation, the signs of which become apparent after surgery, manifests itself:

post hoc

If the eardrum bursts, the symptoms begin to fade over time. This is expressed in the fact that a person gradually improves hearing. This improvement occurs as a result of overgrowth of the gap. The larger it was, the longer this process will be. The determining factors for the regeneration time are the location of the hole and its size. True, if the membrane was damaged due to a complex traumatic brain injury, the victim runs the risk of losing aloud for the rest of his life.

The inflammatory process that affects the ear (or ears) must be treated with the utmost attention and caution. If you decide that the problem will disappear by itself, then otitis media may well become a chronic disease. This in many cases becomes the main cause of large-scale membrane perforation and irreversible hearing loss.

If, nevertheless, the eardrum bursts, you need to remember the symptoms and tell everything in detail to the otolaryngologist, who, based on the collected information data and the results of the examination, will prescribe you a competent treatment.

Rupture or perforation of the tympanic membrane is damage to the membrane due to exposure to a large number of adverse factors. Under the influence of mechanical, physical, chemical or thermal causes, a gap is formed, which disrupts the ability of a person to fully hear sounds. Sometimes there is an independent recovery of the membrane, but only with minor damage. With more severe trauma, a scar may remain, and in especially difficult situations, any violation of the integrity can lead to hearing loss.

There are quite a few predisposing factors that can lead to such a disorder. All of them can be conditionally divided into several groups. But the most common factors for membrane damage are inflammation in the middle ear, exposure to pressure, sharp and unexpected noise, trauma during ear cleaning with objects not intended for this, the pathological effect of hot liquids both at home and at work, as well as penetration foreign objects in the ear.

Any violation of the integrity of the eardrum is accompanied by the manifestation of unpleasant symptoms. Symptoms of a ruptured tympanic membrane are pain of varying intensity and nature, a feeling of congestion in the damaged ear, the occurrence of tinnitus, hearing loss, up to its complete loss.

Diagnosis of such a disorder consists in performing a series of instrumental examinations. When discharge appears, a laboratory study of the contents is carried out. Treatment for perforation of the eardrum consists of the use of drugs or medical plastic surgery. The choice of therapy method is based on the volume of damage.

Etiology

As mentioned above, tympanic membrane rupture can occur from a large number of causes, which are divided into several groups. The first group consists of mechanical factors, which include:

a wide range of ear injuries;
accidental or intentional penetration of a foreign object into the ear cavity;
unskilled performance of medical manipulations aimed at removing the ear plug;
cleaning the ear with objects not intended for this process;
traumatic brain injury.

Physical damage can be caused by:

pressure drop in this area. This can happen due to severe coughing or sneezing, as well as temperature changes during airplane flights or deep diving;
falling on the ear
strong blows to the auricle;
unexpected noise.

The last group of factors - thermal, which can lead to perforation of the eardrum, includes:

ear burns. They can be household or industrial in nature;
ingestion of toxic or chemical substances into the ear.

A little-known group of injuries is military, which includes shrapnel and bullet wounds.

In addition, diseases can become factors in the formation of such a disorder. In particular, such as - acute course or chronic course. These or other factors can lead to both minor injury to the membrane and its complete destruction.

Symptoms

Immediately after the rupture of the eardrum, a pronounced pain syndrome appears, which after a while passes or other signs appear against its background. The following clinical manifestations come to the fore:

appearance and ;
feeling of discomfort in the form of ear congestion;
the occurrence of bloody or purulent discharge, often with an unpleasant odor;
partial reduction or complete loss of hearing;
increase in body temperature;
bouts of nausea and dizziness;
disorientation;
loss of appetite;
sleep disorders;
perforation;
episodes of loss of consciousness;
the exit of air from the auricle indicates a completely perforated membrane.

The severity of symptoms of perforation of the tympanic membrane depends on the intensity of the lesion. Minor trauma, affecting only the outer layer and a small part of the middle, does not lead to hearing loss and the appearance of other signs. Moreover, such damage can be eliminated on its own, which is observed in almost half of patients. Severe damage is often accompanied by fractures of the auditory ossicles or trauma to the internal muscles. With such a lesion, an intense expression of symptoms is observed.

Complications

If symptoms are ignored, as well as when unqualified or incomplete therapy is provided, the consequences of rupture of the eardrum may occur. These include:

the spread of the inflammatory process to the entire area of the inner ear;
feeling some unpleasant symptoms in a healthy ear;
nerve neuritis;
and - develop only when pathological microorganisms enter the affected area;
temporary loss of memory;
the release of cerebrospinal fluid from the ear opening - in cases where the cause of the lesion was a traumatic brain injury;
structural disorders of some elements of the auricle.

With an extensive tear, complete hearing loss can develop.

Diagnostics

What is perforation of the tympanic membrane, the ENT doctor knows - it is this specialist who diagnoses and prescribes treatment tactics. Before conducting instrumental laboratory examinations, the doctor needs to perform several manipulations. In particular, to get acquainted with the medical history and anamnesis of the patient's life. This is necessary to find the causes of the formation of the disease. It also requires palpation and a thorough examination of the affected area, using special tools. This will enable the doctor to determine the degree of rupture of the eardrum, as well as to determine the presence and severity of symptoms.

Instrumental diagnostic methods include:

otoscopy - the study of the affected area and the auditory canal, the search for membrane deformations. It is carried out with the help of special devices of an otolaryngologist - an ear funnel, an otoscope and a frontal reflector;
CT is a way to fully visualize all layers of the ear;
audiometry - a procedure for studying hearing acuity. It allows the doctor to determine the degree of its decrease or to diagnose a complete hearing loss.

Laboratory studies consist in performing a general blood test, as well as microscopic examination of purulent or mucous fluid secreted from the auricle.

Treatment

After a rupture of the eardrum, it is necessary to deliver the victim to a medical facility as soon as possible. Before that, you can not independently provide first aid. In particular, apply cold to the affected ear, rinse it, and also remove blood clots or purulent fluid. The only thing you can do on your own is to put dry cotton wool in the damaged ear and bandage it. If the pain is severe, pain medication may be given.

Professional treatment of perforation of the tympanic membrane consists of several manipulations:

elimination of bleeding;
cauterization - used only with a slight gap;
promoting the free outflow of purulent or mucous fluid;
infusion of antimicrobial drugs into the ear cavity using a catheter;
patch installation - used to repair only minor damage to the membrane.

Drug therapy consists of the appointment:

a course of antibiotics - in the form of ear drops or tablets;
vasoconstrictor drugs;
mucolytics;
anti-inflammatory drops.

In particularly difficult situations with perforation of the eardrum, surgical intervention is sought. This is necessary in the following cases:

complete rupture of the membrane;
partial hearing loss;
violations of the mobility of the auditory ossicles.

There are several ways to treat such a disorder with surgery. To do this, you can assign:

myringoplasty - the intervention consists in replacing the membrane with a flap taken from the temporalis muscle. Sutures are applied with threads, which dissolve on their own after a few weeks;
ossiculoplasty is an operation to restore the auditory ossicles, often with their prosthetics. The procedure is carried out only under local anesthesia;
tympanoplasty - removal or implantation of artificial auditory ossicles.

Often, folk remedies are used in the treatment, which must be used only after consulting a specialist. They promote rapid healing.

Prevention

In order for a person not to have problems with a rupture of the eardrum, it is necessary to adhere to several rules:

clean the ears only with cotton swabs intended for this;
make sure that foreign objects do not penetrate into the ear, especially in children, and also do not remove them yourself;
avoid the influence of strong noise;
do not fly on airplanes and do not dive to depth during exacerbations of ear diseases;
when the first symptoms occur or when fluid is released from the ear, you should immediately contact a specialist.

The prognosis of the disease directly depends on the degree of membrane rupture. With minor damage, half of the patients heal spontaneously. An unfavorable outcome is formed with the progression of complications, as well as in cases of damage to the auditory ossicles or infection with bacteria. This can lead to complete hearing loss, which in turn requires an operation to restore it or the installation of a hearing aid.

Symptoms of perforation of the tympanic membrane

Perforation of the tympanic membrane- this is a violation of its integrity, which occurs due to the inflammatory process, mechanical impact, pressure difference inside and outside the tympanic cavity.

A perforation is said to be when there is a tear or hole in the eardrum, resulting in hearing loss. In addition, an infection can enter the middle ear through a hole in the membrane, which is fraught with the development of otitis media.

Perforation of the tympanic membrane: what are the causes

1. Inflammation in the middle ear. With a disease of otitis media, discharge accumulates, which can also be purulent. Due to a violation of the outflow of this discharge through the Eustachian tube, the fluid accumulated in the cavity of the middle ear presses on the eardrum, which also undergoes purulent fusion. Due to all these processes, it becomes thinner and torn, pus appears from the ear, and the membrane ceases to function as a barrier between the external environment and the middle ear.

2. Acoustic trauma or barotrauma. The membrane may rupture due to the accumulation of fluid on the inside. Pressure from the outside can also lead to a rupture, for example, if the palm is applied too sharply to the ear.

3. Foreign bodies. The eardrum can be injured when cleaning the ear with a cotton swab or any sharp objects.

4. Noise injury. Unexpected loud noise. This results in hearing loss and tinnitus.

Risk factors include:

Fluid accumulation in the middle ear
Excessive scratching in the ear due to itching in the ears
Cleaning the ear from sulfur with hard objects (toothpicks, sticks, etc.).

Symptoms of perforation of the tympanic membrane

Among the main manifestations of rupture or perforation of the tympanic membrane are the following:

Acute ear pain
Bloody discharge from trauma (foreign object, direct or noise trauma)
Purulent or clear discharge due to otitis media
Relief of pain when fluid breaks through the membrane
Noise in ears
Hearing impairment.

Sometimes complications occur, such as:

Hearing loss (usually temporary), with severe head trauma there may be severe or permanent hearing loss.
Chronic otitis media, rupture of the membrane may be accompanied by infection in the middle ear cavity, resulting in the development of chronic inflammation.

Treatment of otitis media with perforation of the tympanic membrane

Perforation of the tympanic membrane occurs, as a rule, with chronic inflammation of the middle ear. A sign of perforation in otitis media is the appearance of various discharges from the ear (serous, purulent or bloody).

Perforation of the tympanic membrane does not pose a serious threat to human health, heals on its own. If it does not heal, then it must be treated in one of the following ways.

Eardrum patch. A small gap is closed with a special paper patch. The edges of the gap are treated with a preparation for growth, then a paper patch is applied. About four such procedures are needed.
Surgical intervention is necessary if the above method is ineffective and the rupture or perforation of the membrane is large. The operation, during which the surgeon stitches a hole in the eardrum, requires general anesthesia.

With uncomplicated damage to the membrane, treatment is minimized. It is forbidden to carry out any active actions on the tympanic membrane and in the external auditory canal, to let drops into the ear during perforation of the tympanic membrane and to wash the ear. If there are blood clots in the ear, they are removed with dry sterile cotton. The walls of the ear canal are treated with a cotton pad moistened with ethyl alcohol and squeezed out, and then dry sterile turundas are placed in it.

When complications such as purulent inflammation of the middle ear appear, treatment is prescribed that corresponds to acute purulent otitis media. If there are damage to the structures of the tympanic cavity, the necessary treatment is carried out until they are eliminated.

Perforation of the tympanic membrane, treatment and prevention measures

The outer and middle parts of the ear are separated by the tympanic membrane. Even atmospheric pressure or too loud sound can damage this delicate membrane. Damage in the form of a tear or hole is called a perforation. It is caused by several reasons. Can a perforated tympanic membrane be treated conservatively or is surgery necessary? Is self-healing possible?

Why does the eardrum rupture?
How to recognize a perforation?
Diagnostics
Therapeutic methods of treatment
When is surgery necessary?
How to prevent perforation of the eardrum?

Why does the eardrum rupture?

Perforation of the tympanic membrane is a complication after suffering diseases of the middle ear, there are a number of ailments that provoke perforation:

Acute otitis media. The inflammatory process in the middle ear with the accumulation of pus develops after SARS against the background of reduced immunity. The membrane under the pressure of pus softens and thins. The tympanic cavity becomes infected, resulting in a disease.
Otitis media with chronic suppuration. Consequence of not fully cured acute otitis media. Has two forms. Mesotympanitis is an inflammation of the auditory tube that infects the mucous layer and forms a through hole in the membrane. Epitympanitis - inflammation of the epitympanic space (attica), characterized by damage to the bone and mucous tissue of the tympanic cavity, the rupture occurs in the upper sections of the membrane.
The impact of atmospheric pressure. It usually occurs when the plane is taking off or landing. Possible when a person sneezes with a closed nose or dives too sharply. The difference between the pressure in the ear and in the atmosphere can cause tympanic membrane pathology, including partial or complete rupture.
Membrane damage by mechanical means. It occurs when you try to free the ear from a foreign body or carelessly clean the hearing organs with sharp objects - a hairpin, a toothpick, a match.
Thermal damage. Occurs when exposed to hot substances at home or at work.
Foreign objects. Children are more often exposed to such troubles. Adults can bring in a foreign body using an item that is not intended for cleaning the ears.
Acoustic (noise) shock. The membrane is able to burst when the pressure of the external environment thickens, which occurs with an unexpected roar, crackle.
Traumatic brain injury is another cause of the pathology of the eardrum. Occurs when an injury affects the tympanic ring.

See more about the causes of eardrum perforation and treatment:

How to recognize a perforation?

The following symptoms of perforation are brought to the patient's specialist:

Pain. The most common cause is otitis media. The injury results in severe pain.
Purulent and mucous discharge. It is said that the inflammatory process became the cause of the perforation.
Blood and bloody secretions. A sign that the membrane has burst due to mechanical damage.
Hearing loss, ear congestion. The reason is excessive accumulation of fluid in the middle ear.
Noise, ringing, buzzing in the ears. It is typical for acoustic perforation, and also as a complication after otitis media.
Nausea and disorientation. They can be caused by otitis, and noise, and craniocerebral trauma. These signs arise due to deep trauma.
Elevated temperature. Usually caused by suppuration in otitis media.
Air escaping from the ear when a person blows their nose or sneezes. Evidence that the eardrum has been completely torn.

Diagnostics

Perforation of the tympanic membrane is diagnosed and treatment is prescribed in several stages:

Medical history - personal data, history of the disease, life, family, the presence of allergies. Especially carefully, the otolaryngologist should inquire about the presence of protracted ailments of the ear and nose, collect information about surgical interventions on the ENT organs.
Examination of the ear by an external method and examination of the site of the pathological change by palpation. The situation in the ear shell, the presence of postoperative scars, swelling, soreness, swollen lymph nodes and other changes are determined.
Otoscopy - examination of the eardrum and external auditory canal. It is carried out with the devices of an otolaryngologist - an ear funnel, an otoscope, a frontal reflector. The method allows diagnosing the degree of membrane damage.
Diagnosis by laboratory method. A study of exudate for bacteriology and a blood test to diagnose the inflammatory process. Helps to choose an effective antibiotic.
CT scan. The best way to visualize the state of the middle and inner ear.
Audiometry. It is carried out to determine the acuity of hearing using an audiometer. The measurement results give an idea of the degree of hearing loss.

Therapeutic methods of treatment

First aid consists in transporting the patient to a medical institution. Before that, you can not apply ice to the ear, rinse it, remove blood clots. The maximum assistance that should be given to the patient is to put a dry cotton swab in the ear or bandage it. Diclofenac or paracetamol - help with unbearable pain.

In half of the cases, a torn membrane heals without special treatment after 2-3 weeks. But this is possible only in cases of minor perforation, not more than a quarter of the membrane area.

Treatment of perforation of the tympanic membrane is performed in the ENT department of a medical hospital. The patient is subjected to certain manipulations and prescribed drug therapy, which depends on the symptoms and diagnosis of the disease:

Stop bleeding. Blood clots are removed with a swab, the walls are disinfected with alcohol and a dry cotton swab is inserted into the ear.
Moxibustion. Used for minor injuries. The edges of the affected area are treated with silver nitrate or chromic acid.
Guarantee of free outflow of exudate.
Infusion of antimicrobial solutions into the ear with a catheter.
Patch. Used for a small gap. An agent that stimulates overgrowth is treated with the edges of a special paper patch. 3-4 such sessions are usually sufficient.
Antibiotic therapy. Indications for the appointment of antimicrobial agents in the form of drops or tablets are inflammatory processes in the middle ear. Amoxicillin, lincomycin, spiramycin, ciprofloxacin, azithromycin, fugentin, tsipromed, norfloxacin are usually prescribed. They are drunk for 8-10 days until complete recovery. Before use, antibacterial ear drops are heated to body temperature, after dripping they lie with their heads thrown back for 1-2 minutes.
Vasoconstrictor drugs. It is used to remove congestion of the mucous membrane and swelling of the middle ear. For the same purpose, nose drops are prescribed. At the same time, the ventilation and drainage activity of the auditory tube is noticeably improved.
mucolytic agents. To dilute the edematous fluid that has accumulated in the middle ear, ACC or fluimucil is sometimes prescribed.
Anti-inflammatory drops. Phenazone, otipax, otinum are drugs with a combined disinfecting and analgesic effect.

These tools are effective with minor tears. If scarring of the eardrum does not occur for several months, surgery will be needed.

When is surgery necessary?

The protective role of the membrane can hardly be overestimated. It is she who serves as a barrier against the penetration of infections into the brain, so if after therapeutic treatment it is not completely delayed, more drastic measures will be needed.

the tympanic membrane is torn completely;
hearing is partially lost or distorted;
impaired mobility of the auditory ossicles.

For perforation of the tympanic membrane, the following types of surgical intervention are used:

Myringoplasty. The torn section of the membrane is replaced with a flap of the temporal muscle sheath. It is sewn with threads, which dissolve in 2-3 weeks.
Ossiculoplasty. The operation helps to restore the auditory ossicles, replacing the damaged areas with prostheses. Apply local anesthesia.
Tympanoplasty. Removal or implantation of artificial auditory ossicles. It is produced when their mobility and integrity are impaired.

How to prevent perforation of the eardrum?

Based on the reasons that provoke the perforation of the eardrum, it is more logical to replace the treatment with preventive measures, here are some simple tips:

In case of inflammation of the ENT organs, do not self-medicate, but consult a doctor.
In case of hearing impairment, do not delay the visit to the otolaryngologist.
Do not remove foreign bodies from the ears on your own.
To avoid trouble with children, carefully observe them.
When taking off and landing an airplane, suck on lollipops, open your mouth, massage your ears.
Avoid excessive noise.

In all cases of suspicion of a violation of the integrity of the delicate membrane inside the ear, you should immediately contact a medical institution, because the ears are too delicate an organ to be neglected.

Perforation of the eardrum (perforated otitis media)

Perforated otitis occurs as a complication of acute purulent otitis media, in which there is a violation of the integrity of the tympanic membrane that separates the outer and middle ear. When the integrity of a part of the ear organ is violated, deafness, hearing loss and impaired perception of sounds often occur.

This disease is dangerous due to the development of a secondary infection, which occurs due to perforation of the eardrum. In this case, the ear is most vulnerable to the ingress of various pathogenic bacteria or infection.

According to statistics, perforation of the membrane is most common in children under 5 years of age.

Possible causes of perforation

acute or chronic inflammation in the middle ear, in which discharge accumulates in its cavity, affecting the eardrum and provoking its thinning and rupture;
the ingress of a foreign object that has a traumatic mechanical effect on the membrane and causes it to rupture;
external and internal, acoustic and barotrauma of the ears. High pressure from the outside, a sharp blow with an open palm on the auricle, pressure fluctuations during takeoff and landing of an aircraft, a loud sharp sound can lead to a rupture of the membrane.
migration of infection from organs close to the ear: oropharynx, maxillary sinus, frontal sinus, nasal passages;
technically incorrect performance of medical manipulations;
traumatic injuries of the skull;
the introduction of infection with the bloodstream in diseases such as influenza, scarlet fever, etc.

Diagnostics

Diagnosis of purulent otitis is carried out with otoscopy performed by a specialist doctor. Otoscopy is a simple, painless procedure during which a plastic or metal funnel is inserted into the external auditory canal, the auricle is pulled up to align the auditory canal and the tympanic membrane is visually inspected.

A rupture of the membrane most often occurs in the lower quadrant and is a triangular gap with jagged edges, from which pus can exit. If it is present, the doctor will take a small amount of fluid for bacteriological analysis to determine the causative agent of the disease and select antibiotic therapy. The larger the perforation, the more hearing impaired.

Sharp pain in the ear may indicate a rupture of the eardrum.

Otitis without perforation is characterized by:

sudden onset of the disease with an increase in body temperature up to 39 degrees;
pain in the ear, radiating to the temple and teeth from the side of the lesion;
hearing loss and tinnitus;
general weakness and malaise.

Purulent perforated otitis is characterized by:

sharp, often severe pain in the ear;
weakening or loss of hearing in the ear on the affected side;
expiration of pus, often with an unpleasant odor, perhaps with an admixture of blood from a diseased ear;
ringing, noise, discomfort in the ear;
dizziness, nausea;
subsidence of pain after the discharge of fluid from the ear.

The release of air from the ear indicates a complete rupture of the eardrum. After the accomplished perforation of the membrane, with the successful discharge of fluid from the middle ear, a slow restoration of hearing sensitivity occurs. Small perforations may heal on their own. Large perforations need to be treated, and degenerative changes in the tympanic membrane may occur.

Perforation in otitis media in children

More often, it is children under three years of age who suffer from otitis media, which is facilitated by their anatomical features. In children, the auditory tube is shorter, wider and more horizontal than in adults. The tympanic cavity in young children is filled with a kind of connective tissue, predisposing to the development of infection here.

In children, the body's resistance to infections is less, the immune system is weaker. Such "children's" diseases as adenoids, acute tonsillitis and adenoiditis only contribute to frequent recurrence and the occurrence of otitis media.

It is important to pay attention to the symptoms of the disease in time. If the child is not yet two years old, then he will indicate pain by anxiety, crying, refusing to eat. When pressing on the tragus of the ear, the crying of the child will intensify, which will confirm the diagnosis.

Important: If this diagnosis is confirmed in a child, in no case should water enter the ear passages. This can cause various complications that are fraught with complete hearing loss.

Ear drops for perforation of the eardrum are selected by the attending physician.

Treatment of perforated otitis should be carried out in a hospital by an ENT doctor and may include:

the use of a special patch for the eardrum, which helps to restore its original integrity;
ear drops with a local anesthetic and antibacterial effect (Anauran, Otofa);
antihistamines (Tavegil, Tsetrin, Loratadin);
vasoconstrictor drops that facilitate nasal breathing and contribute to a better outflow of fluid from the ear (Otrivin, Naphthyzin);
systemic antibiotic therapy (appointed after a doctor's examination);
warming half-alcohol compress on the ear;
surgery can be used in case of a large perforation or in the absence of the effect of the above methods of treatment.

Surgical treatment is the imposition of a bone patch on the perforation site. A skin flap is taken from the area above the ear and a thin absorbable material is sutured along the perimeter of the rupture of the membrane. In the future, the transplanted area takes root and hearing will be restored.

Which doctor to contact

In the presence of symptoms characteristic of acute or perforated otitis, you should immediately contact an otolaryngologist

Prevention

Preventive measures play an important role, especially in children, as the disease is prone to recurrence. Necessary:

correctly and in time to treat developed infections, diseases of the throat, nose, ears;
do not use sharp objects to clean the external auditory canals;
avoid exposure to excessive noise;
support the body's immune system;
teach the child to blow his nose, sneezing;
protect the external auditory canals from exposure to aircraft noise (wear protective earmuffs), dissolve the lollipop during takeoff and landing of the aircraft.

Inflammatory processes of the middle ear require a correct approach and immediate treatment. These conditions do not pose a great danger, but it is important to observe preventive measures in order to avoid the occurrence of complications and relapses of the disease.

How to recognize and treat a perforated eardrum?

The human ear is a complex system. The internal and external cavities are separated by the tympanic membrane. This delicate thin partition is multifunctional. Its main task is to transmit sound vibrations that are recognized by the brain as sounds. But no less important is the protective function that the membrane performs, preventing foreign objects and moisture from entering the inner ear.

When the eardrum is damaged, perforation of the ear occurs (this is a rupture of the eardrum). As a result, sound vibrations are disturbed, which often leads to hearing impairment and loss. The danger also lies in the fact that through the rupture, infections can freely penetrate into the middle ear, thereby causing inflammatory processes up to the development of otitis media. To avoid unpleasant complications, it is important to detect the problem as early as possible and start treatment in a timely manner.

Depending on the circumstances of the impact on the eardrum, mechanical and inflammatory damage are distinguished.

Mechanical damage to the eardrum includes:

sharp sound (shot, explosion);
puncture while cleaning the ears;
a sharp increase in pressure (when immersed in water);
damage by foreign objects.

Cause inflammation of the ear:

fluid in the ear
otitis media;
purulent otitis;
chronic inflammatory diseases of the middle ear.

Attention! Mechanical damage to the eardrum is especially common in children. The inattentive attitude of parents to the child's games with thin and sharp objects sometimes leads to injuries.

Perforation of the tympanic membrane of the ear is always accompanied by sharp pain, which subsides over time. With mechanical damage by objects or sound, the rupture process may be accompanied by slight bleeding.

Inflammatory diseases leading to rupture of the membrane are accompanied by other symptoms:

purulent and watery discharge with various types of otitis media;
hearing loss;
noise in ears;
headache;
increase in body temperature.

Important! Purulent otitis or inflammation in the middle ear does not always cause perforation. Only a specialist can determine the extent of damage. Some ear diseases have similar symptoms but require different treatment approaches.

Diagnostics

If you suspect a perforation of the eardrum, you need to contact an otolaryngologist. The specialist will examine the condition of the ear with the help of visual examination, otoscopy and detailed patient questioning.

The doctor can also examine the damage to the membrane using the method otomicroscopy. To make an accurate diagnosis, it is necessary to find out the frequency and complexity of the course of inflammatory processes in the nasopharynx and ears.

The level of hearing loss can be assessed by standard methods. audiometry. In specialized clinics, computer diagnostics of the condition of the eardrum and its response to sound vibrations are used. The latest hardware method of digital impedancemetry allows you to determine the possibility of hearing restoration and prescribe the optimal treatment.

If a rupture of the eardrum occurs, as a first aid, it is necessary to limit the possibility of infection entering the ear. To do this, insert a cotton ball into the outer ear canal and cover with a bandage.

The auricle is cleaned by a specialist using sterile instruments. If, after perforation of the eardrum, the ear hurts, then they can be discharged analgesics or non-steroidal anti-inflammatory drugs.

In cases where the perforation of the ear is insignificant, the restoration of the membrane occurs without additional treatment within a month.

Therapeutic methods

Therapeutic treatment is aimed at eliminating the inflammatory process.

For this, antibacterial drops Tsipromed are used. , Otipax and the like.

The dosage and frequency of use of pharmaceutical preparations is prescribed by the doctor according to the instructions and the patient's condition.

Standard preparations based on Ciprofloxacin are prescribed 3 times a day in the first weeks of treatment.

In a medical institution, the resulting wound is cauterized with silver nitrate. It is possible to use antibiotics for oral administration in the form of tablets or mixtures.

The use of mucolytic agents is recommended to thin fluids and remove them from the ear. To reduce swelling and remove excess fluids, vasoconstrictor drugs and nasal drops are used. This reduces the pressure on the eardrum and the inner parts of the ear.

With a long overgrowth process, a sticker can be used on the damaged area with treatment with compounds that stimulate tissue repair.

Surgical methods

Surgical methods are rarely used to restore the eardrum. This only happens in case of major damage.. Successful treatment of ear perforation with drugs in most cases gives positive results. Elimination of inflammation and keeping the wound clean most often leads to self-healing of the damaged film.

The surgical procedure to repair the eardrum is called myringoplasty. The operation is performed under general anesthesia using an endoscope, which is inserted into the ear canal. The incision is minimal.

Placed in place of injury "patch" of leather, which is fixed with self-absorbable threads. Ear care consists in regular treatment with antibacterial compounds until the wound is completely healed.

Folk remedies

The use of folk remedies to restore the membrane is usually not recommended. Ear cleaning is carried out only in a dry way. or administration of antibacterial formulations under medical supervision. Therefore, to the question of whether it is possible to wash the ear with perforation of the eardrum with plant juices and infusions, doctors unequivocally answer ban.

Attention! Improper treatment can lead to hearing loss. It is not recommended to use compositions prepared according to folk recipes for laying in the ear.

With perforation of the eardrum, treatment with folk methods is recommended only in the form of taking funds that increase the protective functions of the body.

reception of juices and fruit drinks from cranberries, lingonberries with honey;
increase in the diet of foods containing vitamin C;
infusion of wild rose and hawthorn.

Prevention

In order to avoid injury to the eardrum and subsequent troubles, it is recommended to perform a simple set of preventive measures:

Properly clean your ears. It is especially important to monitor children during hygiene procedures. Cleaning the ear with sharp objects often leads to trauma to the eardrum.
Don't listen to music too loud. You can suffer from a ruptured eardrum by listening to music through headphones at high volume. Strong and harsh noise should be avoided.
Timely and correctly treat diseases of the ear and nasopharynx. Untimely treatment of inflammatory processes in the ear and nasopharynx, according to statistics, is the most likely cause of damage to the eardrum. Self-administration of treatment can lead to the development of otitis media and serious complications in the middle ear with the accumulation of a large amount of fluid, which damages the membrane.
Take action during air travel. When flying on an airplane, it is recommended to use lollipops. Sucking on the candy reduces pressure during takeoff. Earplugs can be used to control the pressure on the eardrum.
Protect your ears from water. Protective caps should be worn when showering and bathing. This will prevent liquid from entering and reduce pressure on the inner parts of the ear.

With timely access to a doctor and following the recommendations, perforation of the ear membrane is easily cured. Modern medicine is equipped with effective methods and drugs to close the gap and prevent complications.

Perforated otitis: stages of occurrence

Acute purulent otitis media (otitis media perforator) is an inflammatory process that occurs in the mucous membrane of the tympanic cavity. A hallmark of the disease is the presence of purulent fluid in the middle ear. It is very common in children under the age of three.

In infants, the middle ear cavity can be easily infected by the entry of microorganisms from the nasopharynx through the Eustachian tube.

The incidence of these inflammatory diseases (eg, sinusitis) peaks in early childhood before the immune system matures. However, this does not mean that adolescents and adults are free from the risk of purulent otitis media.

There are three stages of purulent otitis media:

Preperforative. It is characterized by the development of inflammation of the middle ear cavity and the accumulation of fluid, followed by its transformation into pus. On examination, a reddened (hyperemic) tympanic membrane is visible.
Perforated. With perforative otitis media, the tympanic membrane ruptures, and the accumulated pus begins to pour out of the ear. In this case, the patient usually notes a decrease in pain and feels better. The purulent discharge from the ear is initially copious and sometimes contains blood. During a physical examination, the doctor may observe pus visible through the perforation and pulsing "to the beat" of the pulse.
Reparative. Healing and scarring of damaged tissues occurs.

Puncture of the eardrum with otitis media: signs and symptoms

What is tympanic membrane perforation? The appearance of a rupture in the membrane (the thin membrane that separates the external auditory canal from the middle ear) is called perforation (puncture) of the tympanic membrane. A puncture of the eardrum with otitis media is often accompanied by hearing loss and sometimes fluid (pus) leakage. A perforation caused by trauma or infection is usually accompanied by pain in the eardrum that has burst.

Symptoms and signs of a ruptured eardrum may include:

painful (sometimes unbearably) sensations in the ears;
outflow of purulent fluid (possibly with blood) from the ear;
partial or complete hearing loss;
ringing in the ear(s);
sensation of dizziness and associated nausea or vomiting.

You can see what a rupture of the eardrum looks like in the photo above.

Contact an otolaryngologist, this is an ENT, if any of the above signs or symptoms of eardrum puncture occur with otitis media. The middle and inner ear are very susceptible to injury or infection. Prompt and proper treatment will help preserve your hearing.

If you think you have a pierced eardrum, don't get your ears wet to avoid infection.

Don't swim.
To protect your ear, use a shower cap or place a cotton swab coated with petroleum jelly in your outer ear when showering or bathing.
When the eardrum is punctured, some drops, as well as folk remedies (for example, aloe for otitis media) can only harm and increase pain.

Tympanic membrane in otitis media: diagnosis and impact on hearing

Diagnosis of damage to the eardrum is carried out by examining the ear with an otoscope.

Visually, the perforation looks like a slit in the shape of a triangle with torn edges.
Perforation most often occurs in the lower quadrant of the tympanic membrane.

Usually the size of the perforation determines the level of hearing loss - a larger hole causes more hearing loss than a small hole.

If the tympanic membrane in otitis has been damaged as a result of a severe injury (for example, a skull fracture) and this is accompanied by a malfunction of the inner ear, then hearing loss can be serious, up to deafness.
The result of chronic infection due to damage to the eardrum in otitis media can be a long-term deterioration or loss of hearing.

Perforation of the tympanic membrane in otitis media - stages of treatment

A hearing test must be performed before any perforation correction is performed.

Benefits of tympanic membrane perforation closure for otitis media include:

preventing water from entering the middle ear during water procedures, which can worsen the patient's condition;
hearing improvement;
reduction of tinnitus;
preventing the occurrence of a skin cyst in the middle ear, which can lead to the development of a protracted infection and damage to the structure of the ear.

If the perforation is very small, an otolaryngologist (ear, nose, and throat doctor) may choose to observe it over time to see if the damage heals on its own. Also, the doctor may try to "patch" the patient's eardrum in the hospital and prescribe ear drops containing pain-relieving ingredients. Do not use ear drops for otitis media that are not prescribed by your doctor.

In order for the damage to heal faster and the infection does not penetrate into it, it is covered with tissue paper.
If your doctor thinks that tissue paper will not provide a quick or adequate seal for the hole in the eardrum, or if this method does not help, surgery may be required. It is usually quite successful in the treatment of eardrum perforation in otitis media.

Usually, after the eardrum heals, hearing improves.

Treatment of perforated otitis media

The outer and middle sections of the ear are separated by the tympanic membrane, this septum is quite fragile and it is very easy to injure it. Any damage to this membrane is called a perforation. This phenomenon occurs very often, but not everyone knows what consequences it can entail. This is fraught with various complications, one of which is perforated otitis media.

What is the cause of the disease

Perforated otitis is an inflammatory purulent process of the middle ear, it affects the mucous membrane and the eardrum. The main symptom of this disease is a profuse accumulation of pus in the ear cavity, which occurs until the perforation begins.

This phenomenon is provoked by the following reasons:

otitis media in acute form - occurs after diseases such as acute respiratory viral infections, acute respiratory infections, due to weakened immunity. Pus accumulates in the ear cavity, it presses on the eardrum, which begins to become infected from purulent masses;
otitis media in a chronic form is a response of undertreated acute otitis media. This disease is divided into two groups. The first is mesotympanitis, a disease characterized by inflammation of the auditory tube, it infects the mucous membrane and forms a hole in the membrane. The second group - epitympanitis, this disease affects the tympanic space - attica. It is characterized by inflammation of the bone and mucous tissue of the tympanic cavity, the hole is formed, as a rule, in the upper part of the membrane;
Atmospheric pressure - most often occurs during takeoff or landing of an aircraft, as well as during a sneeze with a closed nose or diving. A sharp pressure drop causes pathological changes in the eardrum, damage or severe rupture;
mechanical damage - develops when the ears are carelessly cleaned with sharp or hard objects: scissors, a hairpin or a match;
burn - occurs when the membrane is thermally damaged;
the ingress of foreign objects - this phenomenon is more typical for children, in adults a foreign body can get into the auricle against their will;
strong noise background - with a sharp and very loud sound, the membrane may burst;
head injury - occurs if the tympanic ring is damaged;
accumulation of pathogenic bacteria in the middle ear.

Treatment of perforated otitis media begins with the elimination of the cause of its occurrence.

Stages of development of perforated otitis media

There are three stages in the development of the disease:

the first stage is called preperforative - at this stage, inflammation of the middle ear occurs, fluid accumulates in it, which subsequently turns into pus. At the initial examination, an inflamed tympanic membrane is observed;
the second stage is perforative. At this stage, a complete or partial rupture of the eardrum occurs. The accumulated fluid begins to come out of the auricle. During this period, the patient observes a decrease in the intensity of pain and an improvement in the condition. There is often blood in the ear secretions;
the third stage is reparative, during this period the healing of the affected tissues begins.

Purulent otitis with perforation, in the absence of correct and timely treatment, can threaten with serious complications. Therefore, at the first symptoms, you should seek help from a specialist.

Signs of perforated otitis media

Warning signs that indicate the presence of a disease are:

pain - pain is of varying intensity, most often strong and sharp;
discharge from the auricle - the liquid is pus or mucus mixed with blood, the discharge from the ear of the ichor indicates mechanical damage to the eardrum;
reduction or partial loss of hearing, congestion - usually the cause is an excessive accumulation of purulent masses in the middle ear;
background noise and ringing in the ears - this phenomenon is observed with acoustic perforation, it can also be a complication after otitis media;
nausea and vomiting - can occur with a concussion, and is also a consequence of acoustic perforation;
an increase in body temperature - purulent otitis media can provoke such a reaction;
the release of air from the auricle when sneezing and blowing your nose is a very dangerous sign, indicating that the eardrum has burst.

Only a doctor can diagnose a disease and find out at what stage it is with the help of tests and various examination methods.

Treatment of perforated otitis media

If a perforation of the tympanic membrane is suspected, the victim should be immediately transported to the hospital. While waiting for paramedics, do not apply ice to the ear, flush or remove pus and blood. The only thing that can be done is to cover the ear with dry cotton or bandage it. If the patient is suffering from severe pain, you can put an injection of Diclofenac.

Treatment of a perforated tympanic membrane is carried out on an inpatient basis, in the department of ENT diseases. Initially, the patient is relieved of pain, then an examination is carried out and treatment is prescribed. Therapy depends on the symptoms and severity of the disease.

In case of ear bleeding, the blood is first removed with a sterile swab, after which the ear cavity is disinfected with a special solution and closed with cotton wool.
The cauterization method is used for minor injuries. In such cases, silver nitrate or chromic acid is used.
Perforated otitis media is treated with an infusion of antimicrobials into the ear using a catheter.
A patch is used to treat a small perforation. The edges of the patch are treated with a special tool that speeds up the healing process. Recovery occurs after three or four procedures.
Antibacterial therapy. It is prescribed to relieve inflammation in the middle ear, drops or tablets are usually used, such as Amoxicillin, Ciprofloxacin, Tsipromed and others. The treatment course is at least 10 days. Antibacterial ear drops need to be slightly warmed up before use.
Vasoconstrictor drugs. Used to eliminate swelling of the middle ear.
Mucolytic drugs are prescribed to help the fluid that has collected in the middle ear and creates swelling to thin out more quickly.
Combined anti-inflammatory drugs. They disinfect the ear cavity and have an analgesic effect.

When is surgical intervention necessary?

The eardrum plays a very important role in the human body. It performs protective functions against the penetration of pathogenic bacteria into the brain. It is for this reason that if it does not heal for a long time, radical treatment is necessary. The help of a surgeon may be needed in cases where:

the eardrum is completely destroyed;
there is distortion, partial or complete hearing loss;
impaired mobility of the auditory cartilage.

There are several methods of surgical intervention:

myringoplasty - the membrane is replaced with a small piece of the temporal muscle membrane;
ossiculoplasty - this treatment helps to restore the mobility of the auditory cartilage;
tympanoplasty - removal or partial implantation in the auditory cartilage, such an operation is prescribed when their integrity is violated.

To avoid this disease, a person needs to give up bad habits, eat right and help strengthen the immune system.

What is dangerous perforation of the eardrum?

The human eardrum performs protective and sound-perceiving functions. Perforation of the tympanic membrane is a condition in which there is a rupture of a thin membrane between the outer and middle sections of the organ. This pathology often accompanies acute purulent otitis media (inflammation of the middle ear). This condition leads to a temporary decrease in hearing acuity.

With a complete or partial perforation of the eardrum, the symptoms are determined by the degree of damage. This pathology is characterized by the following symptoms:

Severe pain in the ears (constant sign). With an injury, the pain in the ear is sharp, sharp and decreases after a while. In inflammatory diseases of the middle ear, this symptom is due to an increase in pressure in the cavity of the organ.
Noise in the ears on one or both sides. It is felt by a sick person in the form of a ringing, hum, hiss or whistle.
Dizziness. It is a sign of damage to the vestibular apparatus. It is often observed with perforation of the membrane against the background of otitis media because the accumulated pus during rupture can rush into the cavity of the inner ear.
Nausea. It is observed when the sound-perceiving apparatus is damaged. Often associated with vomiting.
Mucopurulent discharge.
Increase in body temperature. It is observed when the marginal perforation of the membrane arose against the background of purulent otitis media.
Deafness (hearing loss). Most often it is unilateral.
Weakness.
General malaise.

When perforated, the ear is often blocked. With self-identified symptoms of damage to the tympanic membrane, you should consult a doctor.

Diagnostics

In order to determine damage to the tympanic septum in adults and children, you will need:

collecting an anamnesis of life and an anamnesis of the disease;
otoscopy (external examination of the membrane and outer ear);
microotoscopy (examination with a magnifying device);
palpation;
general blood analysis;
study of the ability of an organ to conduct sound;
CT scan;
bacteriological examination of the secret;
radiography.

To determine the possible causes of perforation, the condition of the mucous membranes of the nose, oral cavity, pharynx and larynx is assessed. For this purpose, rhinoscopy, pharyngoscopy and laryngoscopy are carried out. The simplest method of examination is an examination of the organ of hearing. When perforation is determined: a slit-like defect or a rounded hole in the membrane, purulent masses, tissue swelling and redness. In severe cases, there are signs of damage to the internal muscles of the tympanic cavity.

Traumatic perforation of the tympanic membrane can be caused by a sharp drop or increase in atmospheric pressure (during takeoffs, skydiving, immersion in water), mechanical impact (cleaning the ears with sharp objects), ingress of foreign objects (parts of toys), as well as insects, careless removal of cork from grey, sharp condensation of air and a strong sound.

Other causes of this pathology are:

acute purulent otitis media;
chronic otitis;
fracture of the base of the skull.

Most often, with this pathology of the ears, the symptoms are caused by otitis media. Microbes (cocci, Pseudomonas aeruginosa, moraxella, fungi) take part in the development of the disease. Before damage to the eardrum with otitis media, microbes begin to multiply actively, leading to the formation of pus or serous fluid, which accumulates. It presses on the membrane, against which the membrane is retracted and ruptured.

Predisposing factors are: hypothermia, water in the ear, decreased immunity, SARS, influenza, scarlet fever, measles, diphtheria and other infectious diseases. Less commonly, this pathology occurs when the vestibular apparatus is damaged.

Treatment Methods

With perforation of the eardrum, the treatment of a child and an adult is most often carried out at home after a preliminary medical consultation. With the development of complications, hospitalization is required. With this pathology help:

In case of damage to the external auditory canal and the tympanic membrane with bleeding, tamponade or dressing may be required. The method of treating perforation of the tympanic membrane against the background of purulent inflammation of the middle ear is a thorough toilet. An important task of treatment is the evacuation of accumulated pus. On the video, the opinion of the doctor:

Myringoplasty

The following operations can be carried out:

Myringoplasty. Closure of the defect (hole) with a tissue flap taken from the fascia of the temporal bone. The first time after the operation you need to wear a bandage.
Ossiculoplasty. Replacement of damaged fragments of the auditory ossicles of the middle ear with prostheses.
Drainage.

In the absence of complications, complete recovery is observed within a week.

Medicines

In the treatment of this pathology are used:

Local antibiotics and antimicrobial agents in the form of drops (Otofa, Dancil, Uniflox, Dioxidin, Candibiotic, Anauran, Norfloxacin, Normaks, Tsipromed, Sofradex).
Anti-inflammatory and analgesic drops (Otipax, Otirelax).
Healing agents (Solcoseryl).
Systemic oral antibiotics (protected penicillins, cephalosporins, fluoroquinolones, macrolides). Aminoglycosides are not prescribed due to the ototoxic effect.
Vasoconstrictor drugs (Tizin Xylo, Galazolin, Naphthyzin, Sanorin, Rinostop).
Mucolytics (Fluimucil, Acetylcysteine, Vicks Active Expectomed). They liquefy the viscous secretion and improve its excretion.
NSAIDs (non-steroidal anti-inflammatory drugs) (Otinum, Diclofenac Retard).

The doctor should explain to the patient how to properly instill, why cold medicines should not be used. Before instillation of medicines in the ear, they must be warmed up so as not to cause tissue cooling and relapse. Ear drops for perforation of the eardrum are prescribed taking into account the age of the patient and the tolerance of the components. With discharge from the external auditory canal, antiseptics can be used.

Folk remedies

At home, you can use:

extract (tincture) of propolis;
perforated peroxide (hydrogen peroxide);
rosehip decoction;
juice of plantain and pine needles;
tincture of nightshade leaves.

If dry perforation of the tympanic membrane is detected, then treatment with folk remedies alone is not enough. They are not able to replace surgery and antimicrobial agents.

Contraindications

If the membrane is damaged and sharp acute pain is contraindicated:

warming up (baths, saunas, hot compresses, setting heating pads);
self-removal of pus, blood clots and foreign objects;
rinsing the ear with cold water.

Patients should not fly on airplanes, skydive and dive deep into the water. It is recommended that you stop listening to music with headphones.

Recovery period

Every doctor should know how long it takes for the eardrum to heal. If a small part of the stretched membrane is damaged, healing occurs within 7-10 days. With complete damage, the recovery period is lengthened. If you do not pick objects in your ear, then healing is possible without any consequences.

Complications

With this pathology, the following complications (consequences) are possible:

spread of pus to the entire area of the inner ear with the development of labyrinthitis;
progressive hearing loss;
damage to the auditory ossicles.

Complications develop if purulent otitis media leads to perforation. In this case, meningitis (inflammation of the meninges) and lesions of the mastoid process may occur.

Prevention

To prevent an increase in pressure on the eardrum and its rupture, it is necessary:

do not listen to loud music;
treat existing diseases (ARVI, influenza, sinusitis, rhinitis, tonsillitis);
do not overcool;
treat otitis media in a timely manner;
exclude small objects from entering the ear, since injuries can cause perforation;
exclude foreign objects from entering the ear cavity of children;
refuse to clean the ears with matches and other hard objects.

In case of persistent perforation, in order to prevent complications, it is necessary to consult a doctor in a timely manner. This video will also be helpful:

ICD-10 codes

The code for perforation of the tympanic membrane according to ICD-10 is H72. In the list of international diseases, the classifier distinguishes marginal and central forms of damage.

A healthy lifestyle is the best cure for colds and a way to prevent many viral diseases.

Perforation of the tympanic membrane in otitis media

The eardrum is a thin, funnel-shaped skin that separates the ear canal. Perforation of the tympanic membrane means the formation of any hole or rupture in this place. This education is essential for the implementation of auditory functions. Without the tympanic membrane, the functioning of the hearing organs is impaired, because it participates in the transmission of sound, transmits air vibrations to the hammer. After this, the vibrations are transmitted to the auditory ossicles and to the inner ear. Perforation of the membrane leads to a violation of the perception of sounds, they may not be perceived clearly enough or not perceived at all.

It is important to remember that in addition to being responsible for the quality of sound perception, another function is assigned to the eardrum - protecting the middle and inner ear from infections. When a hole is formed, pathogenic microorganisms can freely enter the middle ear cavity, and this leads to an inflammatory process.

Causes of perforation

Perforation is the formation of a small hole in the eardrum. Violation of the integrity of the overlap can occur spontaneously, but at the same time it can be a necessary measure for the treatment of purulent otitis media. A forced operation is performed if it is necessary to clean the ear cavity from accumulated purulent exudate. Such a membrane delimits the middle and outer ear, therefore, violations of its integrity affect the quality of hearing.

A rupture of the membrane can be triggered by several reasons, as a rule, this occurs as a result of trauma or an inflammatory process.

With adhesive otitis, a pressure drop often occurs, against the background of which the inner surfaces of the ear are covered with scars. Although adhesive otitis is a dry lesion, perforation is often diagnosed.
With purulent otitis media, an accumulation of purulent contents occurs, pressing on the membrane, against which thinning is formed. Damage to the eardrum with this type of otitis media is easy to notice, since there are signs of suppuration. Chronization of the process is extremely dangerous, because against such an unfavorable background, persistent perforation appears, necrosis of the tympanic membrane is often diagnosed.
Traumatic perforation of the tympanic membrane is the result of a negative mechanical impact. This often occurs due to violation of the rules for cleaning the ear canal. Perforation in children may be the result of the introduction of a foreign body into the ear canal.
Injury can be obtained as a result of pressure surges, blast waves, while flying in an airplane, while diving. When the pressure rises, retraction occurs, which causes perforation. Such an injury can be obtained as a result of cotton on the auricle.
Post-traumatic perforation of the tympanic membrane can occur due to head injuries, fractures of the bones of the skull, jaw.
Damage can occur if the acoustic impact is too strong. Sharp and strong vibrations lead to tension and injury to the auditory ossicles.

Treatment of perforation takes a long time. If damage of this kind is suspected, a specialist should be contacted immediately. Only timely assistance will be the key to a full recovery with an absolute restoration of auditory functions.

Possible complications

It is quite simple to limit the influence of negative influencing factors. For inflammation, drops are used that kill pathogenic microorganisms and reduce pressure on the eardrum.

The consequences of tearing the membrane are due to the nature of the injury and related factors. It all depends on the measures taken. Among the possible scenarios for the development of events are:

Healing. This is a completely natural process, the damaged membranes grow together on their own after a while (about 2 weeks), there is no trace of the rupture. Small scars form on the surface, which in most cases do not affect the quality of sound perception. It is important to note the need to use disinfectant solutions during this period. Only an otolaryngologist can choose the most effective drug. Therefore, self-medication is not worth it.
Necrosis occurs with prolonged infection, extensive perforation occurs. There is a high risk of suppuration and membrane death. The process can affect bone formations.
It is not excluded the development of miringitis as a result of infection from the outside.
Labyrinthitis, as a rule, develops in the absence of proper treatment, if the inflammation spreads to the cavity of the inner ear.
Damage to the facial nerve. Nerve endings pass through the ear, including the exit to the facial nerve.
Perhaps the development of mastoiditis.
Cyst formation from epithelial outgrowths at the edges of the tear.
The development of conductive hearing loss.
A dangerous consequence is intracranial complications such as meningitis.

Characteristic symptoms

The symptoms of a perforated eardrum cannot be ignored. First, there is severe pain. Within 2-3 days after the injury, the pain will be quite severe, after about 5-7 days it will pass. It is important to note that in the presence of a purulent inflammatory process of the middle ear, the patient feels pain, but after the rupture of the membrane, on the contrary, it subsides.

Some of the symptoms of perforation include:

feeling of sharp pain inside the ear;
discharge of pus from the ear opening;
the presence of bloody discharge (possibly with acoustic trauma);
hearing loss.

It is worth remembering that if the cause of perforation is an infectious process, there is the possibility of complete hearing loss.

Hearing should be fully restored after the hole has closed. It is important to note that it is very difficult to define clear terms for overgrowth, it all depends on the size of the hole and aggravating factors. If the perforation occurred due to a complex head injury, the patient may completely lose his hearing forever. Inflammatory processes in the ear area must be treated very carefully and timely treatment should be started, delay in this case often causes the development of chronic otitis media and absolute hearing loss.

Diagnostic measures

Diagnostic activities include:

Otoscopic examination. Perforations of the tympanic membrane and signs of otitis media can be detected by an otolaryngologist during the examination.
Otomicroscopy allows you to determine the severity of perforation and determine previously unrevealed nuances of the pathology.
Audiometry allows you to determine the sensitivity of the hearing organs to sounds.
Tympanometry allows you to directly determine the sensitivity of the eardrum.
A number of computer tests are carried out - impedancemetry.

Computed tomography and magnetic resonance imaging are often used when trauma is the cause of perforation of the eardrum. After identifying the cause of perforation, a special course of therapy is selected. For treatment, conservative methods are more often used: physiotherapy and medications, operations on the hearing organs are carried out in extreme cases. The responsibility for the outcome of treatment lies entirely with the patient himself, it is extremely important to protect the injured ear from external factors until complete recovery.

Treatment Methods

Perforation of the tympanic membrane does not require special treatment in most cases. If the hole occupies no more than 25% of the total membrane area, complications do not arise. The patient must follow the doctor's recommendations regarding the protection of the cavity, it is important to limit the conduct of hygiene procedures for the period of treatment.

If the perforation is small, the doctor uses a paper patch, before applying which he treats the edges with a solution that stimulates cell growth. Manipulation is repeated 3-4 times.

An otoscopic examination may reveal particles of dirt or blood in the cavity, then the doctor removes them with a cotton swab and treats the cavity with a disinfectant. Broad-spectrum antibiotics are often used to prevent the spread of infection. If the cause of perforation is otitis complex, a full course of treatment is carried out.

If the area of the lesion is sufficiently extensive and drug therapy does not work, resort to surgical intervention. Myringoplasty is performed under general anesthesia. A small incision is made above the ear to take a piece of skin needed to sew the membranes together. The operation is performed using an endoscope, which is inserted into the ear canal. The edges of the tissues are sutured with self-absorbable sutures. The sutures securely hold the patch, which ensures a speedy healing.

Trying to heal perforation with folk remedies is not worth it. They are not able to replace a full-fledged treatment, and in some cases can cause a deterioration in the patient's well-being. It is also not recommended to use medicines and treat the ear cavity with disinfectant solutions without a doctor's prescription.

Prevention of perforation of the tympanic membrane

It is possible to prevent perforation of the eardrum.

Hearing protection against exposure to loud noise should be provided.
It is necessary to carefully clean the ears from the accumulation of sulfur, since the cause of perforation of the eardrum is often mechanical damage.
You should not self-medicate otitis media - this pathology is one of the most common causes of perforation.

Much depends on the attitude of the patient to his own health. The manifestation of constant tinnitus and pain in the cavity is a reason to visit an otolaryngologist. With untimely treatment of otitis media, a rapid accumulation of pathogenic contents occurs.

Effective treatment of perforated otitis media

Perforative otitis is called an acute purulent process in the middle ear, affecting its mucous membrane and tympanic membrane. The disease has a characteristic feature - constantly accumulating purulent masses in the tympanic cavity until perforation occurs and they exit the ear canal.

This pathology, as a rule, is inherent in infants and preschool children. It is during this period that the maturation of immunity in the baby occurs, because of which his body becomes very susceptible to various kinds of diseases. However, such statistics are by no means a guarantee that perforated otitis cannot occur in older people.

Causes of the disease

There is a fairly widespread opinion among the people that acute otitis media can be “caught” if you walk in drafts or walk with your head uncovered in the cold season.

In part, there is some truth in this - a common cold obtained in this way can give complications to other organs, including the organ of hearing. However, it is impossible to get infected with perforated otitis initially in a similar way.

Otitis, as a rule, begins to develop due to the action of harmful microorganisms that have entered the auditory tube in various ways. It is the accumulation of bacteria in the ear that causes acute purulent inflammation. This happens in the following cases:

Prolonged inflammatory processes in the body, of an infectious or viral nature;
The entry of bacteria that cause influenza, measles or scarlet fever into the middle ear cavity through the circulatory system;
Incorrect technology of blowing the nose, in which the patient has both nostrils involved at once, and the lips are tightly closed.

However, the cause of perforated otitis media may be the lack of normal ventilation of the auditory tube due to such factors:

Regular inflammation of the adenoids (critically enlarged nasopharyngeal tonsils) with indications for their removal;
Anomalies in the structure of nasal conchas;
Injury to the nose, resulting in a deviated septum;
Injury to the ear canal, in which the integrity of the eardrum was broken;
The entry of pathogenic bacteria into the ear canals from the outside.

The development of perforative otitis is also possible as the spread of the inflammatory process from the outer ear to the inner. Acute otitis externa is caused by fungi and pathogenic bacteria that have penetrated the skin due to:

ear injury;
Unsuccessful self-cleansing of the ear canal from sulfur;
Burns of the outer ear;
Jamming of various objects in the auricle;
Ear exposure to hazardous chemicals.

How to recognize purulent otitis?

Acute purulent form of otitis media, as a rule, is accompanied by the following symptoms:

Swelling and redness of the external ear;
Multiple suppurations on the injured area;
Severe pain syndrome;
Increase in body temperature;
Markedly enlarged lymph nodes.

Symptoms of perforative otitis media are almost identical in both an infant and an adult. The only significant difference is that otitis media in children may have more pronounced symptoms and be accompanied by unbearable ear pain.

Another sure sign of purulent otitis media is a feeling of congestion in the ears, the presence of atypical sounds and noises that spread throughout the auditory tube, as well as in the temple area or the back of the head.

There are frequent cases when discomfort can radiate to the jaw, which creates the illusion of unbearable toothache and prompts the patient to consult a dentist.

Simultaneously with the above symptoms, discomfort in the ear affects the general well-being of the patient. The patient loses his appetite, insomnia and frequent headache appear. Many patients note that a certain pulsation and tingling is felt inside the ear, which intensifies during coughing, blowing the nose, or when chewing with the jaw.

Additional signs by which a purulent process in the middle ear can be suspected include:

Sudden hearing loss
Inflammation of the lymph nodes in the cervical-facial region;
The presence of discharge from the ear canal.

This symptom can affect one or both ears at once. In the latter case, the disease will be called bilateral purulent otitis media. If only one ear is included in the inflammatory process, then otitis media is called unilateral.

Such otitis, in addition to local manifestations, is also characterized by general intoxication of the body. The patient experiences weakness and malaise, he is sharply thrown into a fever.

It is also possible that there are signs resembling an allergic reaction - sore throat and nose, the release of large amounts of fluid, swelling and congestion of the nasal canals.

Breakthrough of the tympanic membrane - how to determine and what to do?

At the moment when the tympanic cavity is no longer able to hold the fluid accumulated in the middle ear, a rupture occurs and all its contents come out. At the site of the rupture, a perforation is formed - a small hole in the membrane that delimits the external and middle auditory canal.

Patients who have undergone a puncture of the membrane claim that during this period their hearing deteriorated significantly, and large volumes of exudate began to stand out from the ear. If the damage to the membrane was caused by trauma, then the patient will experience pain in the affected area.

Signs that indicate a perforation in the eardrum include:

Incredibly severe pain in the affected ear;
Outflow from the ear canal of purulent contents with impurities of mucus and blood;
Sudden hearing loss;
Deafening ringing inside the affected ear;
Weakness and dizziness;
Nausea, sometimes accompanied by vomiting.

Attention! If you experience any of the above symptoms or conditions, tell your otolaryngologist immediately. The sooner qualified assistance is provided to you, the more chances you have for a successful outcome of the situation and the preservation of hearing.

You should also remember what you should never do if you suspect a ruptured tympanic membrane:

Take a shower or bath without a special cap;
Swim in open water;
Independently try to clear the ear of pus;
Apply any folk methods without consulting a doctor.

Healing procedures

The methods used in the treatment of purulent otitis are directly related to the nature and degree of neglect of the inflammatory process. In order to get rid of otitis in its first stages, the patient is prescribed a course of physiotherapy procedures: heating with a blue lamp and warm compresses on the area of the affected ear.

Medication methods of treatment imply the appointment of the following series of drugs to the patient:

Disinfecting ear drops containing an anesthetic in the composition;
Nasal vasoconstrictors;
Anti-temperature tablets and medicines;
antihistamines;
Antivirals.

Treatment of perforated otitis media must be comprehensive. This means that along with the primary task - the rehabilitation of the organ of hearing, no less attention should be paid to other concomitant diseases. These include various diseases of the throat, upper pharynx and nasal concha.

The decision to prescribe antibiotic therapy to a patient can only be made by the attending physician. As a rule, otitis at the initial stage does not require the use of antibiotics, and the patient follows the doctor's instructions while at home.

The use of folk recipes in the treatment of such otitis media is permissible only after consultation with a specialist. Also, do not forget that treatment with the help of alternative medicine is only an addition to drug therapy, but not a replacement for it. The most common home remedies for suppurative otitis are:

Cleansing the ear canal with cotton swabs soaked in a decoction of field chamomile;
The use of ear turundas soaked in mint tincture or plantain decoction;
Eating foods rich in vitamin C. For example, tea with rose hips or lemon.

Otolaryngologists agree that even the most harmless cold should be cured on time, because it can easily provoke an acute inflammatory process in the ear.

You can prevent the occurrence of perforative otitis in a child if you explain to him the importance of regular care for the auricle and teach the baby to blow his nose correctly.

Adults can also avoid the disease by maintaining a healthy lifestyle and maintaining the body's defenses at a normal level. Purulent otitis, which has not been cured in time, can go into a chronic stage or lead to such serious consequences as meningitis, sepsis, thrombosis, and irreversible deafness.

Perforated otitis media

Perforated otitis is a form of inflammation of the middle ear, in which, due to purulent effusion, the tympanic membrane breaks and the contents of the cavity exit through the auricle. This type of disease is considered quite severe. Left untreated, it often causes permanent hearing problems or even complete hearing loss. Most often, this pathology affects one ear, but there are also bilateral inflammations.

According to statistics, otitis media most often occurs in early childhood. Babies under 3 years old are the most common part of all the sick, since the structural features of their ENT organs favor the faster spread of microbes. However, this fact does not mean that the disease in question does not concern adults. The risk of getting purulent inflammation of the middle ear exists at any age.

Stages of perforated otitis media

Preperforative phase - infection of the internal cavities of the ear occurs and the accumulation of purulent discharge in them.
Perforative phase - due to the pressure of the fluid and its impact on the surrounding tissues, the tympanic membrane ruptures with the release of pus.
Reparative phase - tissue healing and restoration of functions.

The main reason for the development of this disease is the reproduction of pathogenic microorganisms in the middle ear cavity. And they get there in different ways:

spread of infection from adjacent organs (pharynx, nasal passages and sinuses);
the introduction of microorganisms through the blood with measles, scarlet fever, influenza, tuberculosis;
injury to the ear cavities or the ingress of foreign objects.

Predisposing to the appearance of perforative otitis are those factors that interfere with the free passage of air in the upper respiratory tract and the Eustachian tube: deviated nasal septum, polyps, adenoids, neoplasms, adhesions. There are frequent cases of inflammation of the middle ear when blowing your nose with both nostrils at the same time, especially in pediatric practice.

Symptoms of perforated otitis media

With the development of purulent otitis media preceding the rupture of the tympanic membrane, characteristic complaints and clinical signs occur. In the first stage of the disease, symptoms are both local and general:

Pain on the affected side (aching, pulling, bursting). Sometimes spreads to the maxilla or occiput.
Hearing impairment (noise, stuffiness, muffled sounds).
Possible swelling and redness of the ear.
Often boils in the ear canal.
Temperature increase.
Deterioration of well-being (chills, aching joints and bones, headache, lack of appetite, tearfulness, sleep disturbance).
Enlargement of the submandibular, behind the ear and cervical lymph nodes.

Depending on the degree of inflammation, these signs may appear brightly or be blurry. In children, most often, all symptoms appear more clearly than in adults, causing severe anxiety and moodiness.

The second phase of perforative otitis media can be manifested by sharp pain when the eardrum is ruptured, which quickly subsides. In this case, the inflamed ear loses its hearing. Usually, purulent masses come out with blood from the external auditory canal within a few days, bringing an improvement in overall well-being.

The reparative phase begins after the complete discharge of fluid from their middle ear. At this time, there is a gradual restoration of sensitivity to sounds. With a small size of the hole, it itself can recover in a short time without any special traces and dysfunction. Larger breaks recover over a longer period of time, and degenerative changes in the middle ear mucosa and tympanic membrane may develop.

If a sick person has not received full treatment, then there is a high probability of the disease becoming a protracted form. In this case, the symptoms of otitis media become blurred and mild. The inner surface of the ear cavities is gradually replaced by connective tissue, adhesions appear, and hearing is lost. With the development of other infections, the signs of the disease may increase: pain appears, discharge from the auditory canal.

Frequent complications of perforative otitis media are a chronic form of purulent otitis media, mastoiditis (inflammation of the mastoid process), abscess, temporary or permanent hearing loss. These diseases require long-term treatment and the use of potent drugs, so it is better not to bring them to their appearance.

Diagnostics

Without the participation of a doctor before the rupture of the eardrum, it is impossible to identify this form of inflammation of the middle ear on your own. If you have complaints of earache, you should consult an otolaryngologist. During the examination, the doctor determines the nature of the effusion in the auditory canal, bulging or perforation of the eardrum.

To clarify the diagnosis and exclude complications, radiography and audiometry are performed. Laboratory diagnosis in this disease is often limited to a general and biochemical blood test, in some cases, a discharge is cultured to determine the pathogen and its sensitivity to drugs.

Treatment of perforated otitis media

The treatment of perforated otitis requires an integrated approach. It takes into account the source of the disease, its causative agent, the presence of individual intolerance to drugs, the severity of complaints. For the treatment of this form of otitis media, the following groups of medicines are used:

Antibiotics and antimicrobials (Amoxicillin, Flemoklav, Augmentin, Cefazolin).
Anti-inflammatory and analgesic drugs (Baralgin, Dexalgin, Aspirin, Ibuprofen) to relieve pain and general symptoms of inflammation.
Glucocorticosteroids (Dexamethasone, Prednisolone) to reduce swelling and inflammation.
Antihistamines (Suprastin, Diazolin, Claritin, Diphenhydramine) to reduce tissue swelling and prevent drug allergies.
Vasoconstrictive drops in the nose (Nafthyzin, Galazolin, Tizin, Nazivin) to expand the lumen between the ear cavity, nose and throat.

If conservative treatment does not bring the desired effect, then a surgical opening of the tympanic cavity with drainage and administration of drugs is used. Through the drainage, the cavity is subsequently washed out until the signs of inflammation and intoxication disappear and pus ceases to separate.

During recovery after such an operation, physiotherapeutic procedures are prescribed: warming up, ultraviolet irradiation, exposure to currents of various frequencies, electrophoresis. At this time, it is allowed to add alternative methods of treatment, but only after consultation with the attending physician. Such methods include laying cotton wool soaked in decoctions of medicinal herbs in the ear: chamomile, succession, plantain, aloe. You can bury 1-2 drops of sea buckthorn oil, propolis tincture.

It is important to consider that the independent use of any drops in the ears without a doctor's examination is unacceptable! In the event of a rupture of the eardrum, such self-treatment will only bring harm. In this case, you need to stop the pain in the ear only with pills or injections of painkillers. Self-treatment for perforated otitis media is very dangerous!

Slanko Anna Yurievna

The human hearing organ is quite complex and consists of three sections: external, middle and internal. The eardrum or membrane is located between the first two and, in fact, separates them. It is a thin plate of connective tissue of a rounded shape, fused in diameter with the walls of the external auditory canal. It is located on the border between the latter and the middle ear cavity. Outside, the membrane is covered with skin, inside - with a mucous membrane.

Perforation of the tympanic membrane usually occurs when a mechanical impact on it occurs as a result of a general injury, accident, or violation of the rules for caring for the external auditory canal.

What are the functions of the tympanic membrane?

The main functions of this important body are:

Isolation of the middle ear cavity from the external environment. Creation of a closed air chamber necessary for high-quality sound transmission.
Protection of the air chamber of the middle ear from the penetration of air, water, foreign objects, including microorganisms (bacteria, fungi, etc.).
Direct participation in sound conduction. The membrane is attached to one of the three auditory ossicles of the sound-transmitting apparatus. Air vibrations in the external auditory canal are captured by it and transmitted to the above-mentioned bones and further to the perceiving part of the hearing organ.

If the eardrum bursts, then a hole is formed in it - a "hole" - through which the middle ear cavity communicates with the external environment. As a result of membrane damage, complications can develop:

Infection of the middle ear and auditory tube with the development of bacterial and;
The penetration of fungal microorganisms leads to disease;
Decreased ability to perceive sounds.

If the cause of the rupture of the tympanic membrane was a trauma to the skull and it was accompanied by a fracture of the temporal bone, then the infection enters the labyrinth with the development of inflammation (). With combined damage to the tympanic membrane and auditory ossicles, the patient often develops adhesive otitis media (adhesive), in which connective tissue adhesions form in the middle ear chamber, which leads to deafness of the victim.

Causes of violation of the integrity of the tympanic membrane

According to the nature of the factor that caused its rupture, damage is distinguished:

Most often, the influence of mechanical factors is associated with:

General trauma of the skull, when the temporal bone is damaged with the cavity of the middle ear enclosed in it;
The ingress of a foreign body into the external auditory canal;
Violation of the rules for cleaning the ear canals. The latter is more often observed in a child, especially in infancy, with rough cleaning of the ears with cotton swabs. Also, children often have cases of self-injury with sharp objects.

Symptoms of eardrum injury

Patient complaints:

Sharp at the moment of injury, soon subsiding;
Feeling of congestion of the organ of hearing and noise in it of varying degrees of intensity;
Decreased ability to hear up to complete.

A severe injury affecting the balance apparatus is accompanied by impaired coordination, nausea, and dizziness.

Objectively, there may be the following symptoms of damage to the eardrum:

The release of air from the affected ear canal when coughing, sneezing, strong exhalation;
Leakage of a clear fluid (perilymph) from a damaged balance organ.

Injury to the skull and a sharp drop in atmospheric pressure (barotrauma) may be accompanied by the release of blood from the ear canal.

If the rupture of the membrane is complicated by otitis media or labyrinthitis, purulent outflows will be detected.

In young children under 2 years of age, the diagnosis is complicated by the absence of meaningful complaints and the silence of the parents of the previous ear injury or ignorance about it. Usually they turn to the doctor with suspicion of deafness of the baby of a congenital nature.

Additional diagnostics

In the diagnosis of this pathology, the medical history (anamnesis) with a mention of the injury, as well as the patient's complaints, is very important.

Also important are the results of a clinical examination - an external examination of the organ of hearing, an internal study (otoscopy). With this, the otorhinolaryngologist can see the degree of damage to the membrane, the condition of the surrounding tissues.

Sometimes an examination reveals an inverted tympanic membrane, mistaken for traumatic injury. However, this condition occurs when the movement of air through the Eustachian tube is difficult due to catarrh of the mucous membrane lining it. This reduces the pressure in the middle ear cavity, the auditory membrane is drawn into it. With a pronounced process, sometimes it becomes thinner and fits the auditory ossicles, creating the appearance of its absence. However, in this case, there are no signs of acute or chronic injury: hemorrhages, swelling, redness, tissue micro-ruptures. When blowing the auditory tubes, the membrane protrudes into the ear canal, which can be seen with otoscopy.

This pathology in the chronic course changes the correct configuration of the joints of the bones, causes overgrowth of the joint spaces between them, which disrupts sound conduction and contributes to the development of deafness.

It is necessary to distinguish perforation of the eardrum from its retraction for the reason that the treatment is completely different. In the latter condition, the blowing of the Eustachian tubes by various methods and the subsequent therapy of the inflammatory process in them are used to restore patency.

To assess the functional state of hearing and the vestibular apparatus, vestibulography, audiometry and other methods are performed. If signs of a purulent infection are found, a bacteriological examination of the discharge from the ear canal is prescribed with the determination of sensitivity to antibacterial drugs.

Combined damage (car accident, railway wreck, fall from a height) requires skull radiography, CT, MRI.

Therapy for damage to the tympanic membrane

Some time after the formation of the hole, spontaneous restoration of the tympanic membrane is possible with little or no violation of its functions. This can happen with shallow damage, affecting no more than 25% of the organ area. The regenerative capabilities of the connective tissue are relatively large, which allows the auditory membrane to heal even with more severe injuries, however, in such situations, a scar forms on it and calcium salts are deposited. Scarring and calcification tighten the membrane, change its shape and configuration, which affects the quality of its work as an organ.

If the doctor, having assessed the amount of damage, sees that spontaneous regeneration of the membrane is impossible without a subsequent breakdown of its functions, then he immediately suggests plastic surgical methods of treatment. As a material, both own tissues (fascia, muscle shreds) and foreign (chicken embryo amnion) are used.

Conservative therapy

Important! Use with perforation of the eardrum is prohibited, since you can bring the infection into the "open" middle ear.

If the lesion is not severe, the patient is instructed to do nothing, only to watch the outer part of the ear canals. If there is blood in the ear canal, it must be carefully removed with a cotton swab moistened with alcohol, without penetrating deep into the ear. A foreign body, if found in the passage, is also removed. This must be done by a doctor. If necessary, he will place a sterile cotton swab in the affected ear canal to protect the tympanic membrane and underlying tissues. The doctor also decides on the need for surgical intervention (suturing a hole in the membrane) in cases where conservative treatment has not worked for some time, and the damaged membrane has not overgrown.

With the development of purulent inflammation, systemic antibiotics are used, selected taking into account the sensitivity of microbes to them.

For young children, in most cases, even with an uncomplicated rupture of the auditory membrane, hospitalization is indicated to avoid inflammation and other consequences.

In patients with complicated damage to the tympanic membrane, in the event of a neurosensory or conduction membrane, surgical interventions are performed to restore hearing (implantation of high-tech hearing devices). They also use modern hearing aids.

Prevention of pathology

Since it is traumatic in nature, this problem can be prevented by general prevention of injuries, by following the rules for caring for the hearing organs. Children need to be supervised, strictly forbidding the insertion of objects into natural openings and limiting dangerous games that can cause excessive sound waves, head injury.

Video: the structure of the human ear

Not everyone knows what a perforation of the eardrum is. In case of damage to the eardrum, a rupture occurs in it. This gap is called perforation. For this reason, the perception of sound changes, and a person has hearing problems. Perforation of the membrane is dangerous because through it an infection can easily enter the middle ear. It is very important to identify the pathology in a timely manner and begin the treatment of perforation of the tympanic membrane. On this basis, many are wondering how to properly handle the ear during perforation and what drops can be used.

The root causes of the gap may be different. Usually they have an inflammatory or traumatic nature of occurrence. Mechanical injuries include:

sharp sound;
damage by a foreign body;
puncture at the time of cleaning the ear;
sudden pressure surges.

Foreign body injury is most common in children.

Inflammatory causes include:

otitis media;
penetration of fluid into the ear;
purulent otitis;
chronic inflammatory diseases of the body.

Whatever the cause of the pathology, it is urgent to visit a doctor.

Symptoms

Immediately after damage to the tympanic septum, a person experiences severe pain. Symptoms of tympanic membrane perforation are:

extraneous sounds in the ears;
the exit of purulent mucus from the organ, if the impulse arose as a result of otitis media;
with perforation of the eardrum due to trauma, bloody compartments may appear;
hearing loss.

In case of injury to the inner ear, the patient experiences dizziness. If the eardrum is completely torn, then air comes out of the organ of hearing. With a small injury, the signs are not pronounced. The severity depends on how damaged the organ. With a slight damage, the pain recedes quickly and hearing is only slightly reduced. With extensive trauma, the inflammatory process can go to the entire organ.

Complications

With perforation of the tympanic membrane, the symptoms of which may not be very pronounced, it is important to start a timely cure. Otherwise, complications may arise. If the treatment of perforation of the tympanic membrane was not competent, then there are consequences of a rupture of the tympanic membrane, which is dangerous to health. These include:

unpleasant symptoms appear in an ear that has not been damaged;
perforative otitis;
nerve neuritis;
temporary memory loss;
structural changes in some elements of the auricles;
labyrinthitis;
encephalitis;
meningitis;
separation of cerebrospinal fluid from the ears.

With an extensive rupture of the septum, complete hearing loss is possible.

Treatment

Only a doctor can answer how to treat the disease. Most often prescribed drops. Perforation of the tympanic membrane should be subjected to competent timely treatment. Especially if the damage is observed in a child. If the eardrum has ruptured, it is necessary to restore its normal appearance as soon as possible. First of all, if a hole has appeared in the eardrum, it is necessary to prevent the infection from penetrating through it into the inner ear. To cover the holes, insert a cotton ball into the ear and apply a bandage.
In case of problems with the ear, only a doctor can clean it. Cleaning is carried out only with sterile instruments. If after an injury in a patient, then in this case analgesics are prescribed. No less effective are antiphlogistic nonsteroidal agents.

If the gap is insignificant, then the repair of the perforated membrane occurs without additional treatment.

Therapeutic methods

Therapeutic cure is aimed at eliminating the inflammatory process. For this, doctors prescribe antibacterial drops. These include:

Otipax;
Tsipromed;
Otof and others.

The dosage and frequency of application of drops must be obtained from the attending physician. The doctor prescribes them according to the symptoms and condition of the patient. Drops based Ciprofloxacin shown to be used three times a day during the first week of treatment.

If the gap is small, then drops are not applied. The specialist uses a special paper patch to close the gap. The edges of the hole are necessarily treated with a growth-stimulating drug, after which a patch is applied.
When an accumulation of blood clots is detected, they are removed with a cotton swab, followed by treatment with alcohol.
In the case of a small area of damage, specialists cauterize the wound that has arisen. This is done with the help of silver nitrate or chromic acid. These tools are used to treat the edges of the wound.
Experts recommend taking mucolytic drugs that help thin the mucus. After receiving the department, they are promptly removed from the organ of hearing. To reduce swelling and eliminate excess fluids, the use of vasoconstrictor drugs in the nose is indicated. This allows you to reduce the pressure exerted on the membrane and the internal parts of the organ.
In order not to face the spread of infection in the middle ear, antibiotic therapy is prescribed. When acute otitis is detected, a full course of treatment is carried out. This is necessary so that the acute form does not turn into chronic otitis media.

Surgical methods

If the therapeutic method did not give any improvements, or if the affected area is too extensive, then surgical intervention is indispensable. Most often, with perforation of the eardrum, treatment with medication has a positive effect. Elimination of the inflammatory process leads to self-healing of the membrane.
The surgical procedure to repair the septum is called myringoplasty. This intervention is performed under general anesthesia using an endoscope. It is inserted into the ear canal. A piece of skin is sewn to the membrane with self-absorbable threads. Overlapped sutures help hold the patch in place. The threads dissolve within a few weeks. Ear care during this period consists in its treatment with antibacterial drugs.
After the operation, a person may experience a feeling of discomfort. In the early days, it is not recommended to breathe through the nose. This will help relieve excessive pressure on the regenerating eardrum. Otherwise, a piece of skin will move to the side, which will disrupt the healing process.

Folk remedies

Often, patients use traditional medicine recipes for a speedy recovery. This method cannot replace the therapeutic one, but it is an excellent addition to traditional methods. To speed up the healing of an injury, you need to eat more foods rich in ascorbic acid:

citrus;
hawthorn;
juice or fruit drink from cranberries;
rosehip decoction.

Useful will be the use of grapes of sweet varieties. A swab for the ear canal is recommended to be moistened with plantain juice or pine needles. It is also effective to moisten with a tincture of nightshade leaves. To prepare it, you need 2 tablespoons of herbs to pour 0.5 liters of alcohol. Leave to infuse for 14 days.
The hole remains for a long period of time after healing. For this reason, it is necessary to keep the entire healing process under control. This will help stop hearing loss and the transition of the disease to a chronic form.

Prevention

In order to protect yourself from damage to the membrane and from all possible complications, it is imperative to adhere to preventive measures:

Gently and properly cleanse the body. It is especially important for parents to pay attention to hygiene procedures in children. In case of cleaning the organ with sharp objects, injury may occur.
Do not listen to loud music. It is important to avoid noise.
Timely and competently undergo a course of treatment for diseases of the nasopharynx and ear. The most likely cause of rupture of the septum is the untimely cure of inflammatory processes. With self-administration of drugs, otitis media may begin to progress and other consequences may develop.
Protect ear passages from liquid penetration. When taking a bath, it is recommended to use special caps that prevent liquid from entering. This reduces pressure on the inner ear.
Take action at the time of air travel. To regulate the pressure, use special earplugs.

From all that has been said, we can conclude that it is possible to avoid such a disease only if all preventive measures are observed. With timely access to a doctor, the disease is treated very simply without complications.