Eardrum It is a thin, funnel-shaped skin that separates the ear canal from the middle ear.
The role of the eardrum is to transmit air vibration - sound - to the hammer. Its vibrations are transmitted to this auditory bone, and further along the system of the auditory ossicles - the incus and the stapes - to the inner ear.
Perforation or rupture of the tympanic membrane
A perforation of the tympanic membrane means there is an opening or tear in it. In the event of a ruptured eardrum or the presence of an opening in it, its vibrations can be disrupted, which, in turn, leads to hearing impairment.
In addition, the presence of a hole in this membrane contributes to the entry of infection into the middle ear cavity, which is fraught with inflammation - otitis media. The reasons that lead to perforation or injury to the tympanic membrane are different. These can be inflammatory processes in the ear, as well as ear injuries, including noise injury.
Causes of perforation or rupture of the tympanic membrane
Inflammatory process in the middle ear
With inflammation in the middle ear - otitis media - discharge accumulates. This discharge can also be purulent.
Due to the rather small volume of the middle ear cavity and due to a violation of the outflow of this discharge through the Eustachian tube (since it is also clogged in this disease), the fluid that accumulates in the middle ear cavity presses on the eardrum.
In addition, the membrane also undergoes purulent fusion. As a result, they become thinner and torn. This is manifested by the separation of pus from the ear. In this case, the membrane no longer has a barrier function between the external environment and the middle ear.
Barotrauma, or acoustic trauma
If fluid accumulates on the inside of the eardrum, it can rupture. However, pressure from the outside can also lead to rupture.
This happens, for example, when the open palm is pressed sharply to the ear, sometimes rupture of the membrane can occur in flight during the ascent or descent of the aircraft, when the pressure changes.
It is not for nothing that it is advised to open your mouth or suck on candy to equalize the pressure on the eardrum, since air through the Eustachian (auditory) tubes enters the middle ear with each sip.
Noise injury
A sudden, harsh noise (such as an explosion) can also rupture or perforate the eardrum. In addition to a sharp decrease in hearing, there may be pronounced tinnitus (tinnitus). Over time, tinnitus goes away and hearing is partially restored.
Foreign bodies
Sometimes cleaning your ear canal with a cotton swab or other objects can injure your eardrum. It also promotes infection in the middle ear.Symptoms of a ruptured eardrum
A ruptured eardrum, especially early on, can be quite painful. Symptoms of a ruptured eardrum include:
Descriptions of the symptoms of a ruptured tympanic membrane
Complications of a ruptured eardrum
Usually, a ruptured or perforated eardrum does not pose a serious health threat to the patient. Heals on its own within a few weeks.
Loss of hearing
This is usually a temporary complication. It goes away as the ruptured membrane heals. Naturally, the larger the gap, the longer it heals and the longer the hearing loss lasts. The degree of hearing loss is affected by the location of the tear or perforation. In severe traumatic brain injury, which is accompanied by damage to the structures of the middle or inner ear, hearing loss can be severe and permanent.
Recurrent middle ear infection
Extensive membrane perforation or rupture can be accompanied by recurrent infection of the middle ear cavity, resulting in chronic inflammation. This can contribute to permanent hearing loss.
Eardrum rupture treatment
In most cases, the perforation of the membrane heals on its own without complications within a few weeks. If the membrane does not heal, treatment is necessary.
Tympanic membrane patch
If there is a small tear or perforation, the doctor can cover it with a paper patch. Before this, the edges of the break are treated with a growth stimulation drug, after which a paper patch is applied to the site of the break. Three to four such procedures may be required to completely close the gap.
Surgery
In the case of a larger rupture or perforation of the membrane and if the above method is ineffective, surgical intervention may be required. The operation to restore the integrity of the tympanic membrane is called tympanoplasty or myringoplasty.
The operation is performed under general anesthesia. The surgeon makes a small skin incision over the ear. A thin flap of skin is taken from it. It is used to suture a hole in the eardrum.
The surgeon inserts a special microscope into the ear canal and then the whole operation is carried out with its help through the ear canal. The eardrum is lifted and the flap is placed against the opening in it.
Special absorbable materials are placed on both sides of the membrane to help keep the flap in position until it heals completely. After a few weeks, this material is completely absorbed.
A tampon moistened with an antibiotic for a period of three to four weeks is inserted into the ear canal until the flap is completely engrafted on the tympanic membrane.
Some pain and discomfort may occur at first after surgery. It is recommended not to blow your nose or make sudden pulling movements through your nose. This is due to the fact that on the back wall of the nasopharynx there are openings of the auditory (Eustachian) tubes that connect the nasopharyngeal cavity with the tympanic cavity.
The role of these pipes is to equalize the pressure in it. With sudden air movements in the nasopharynx, the pressure in the tympanic cavity can increase, which leads to the movement of the tympanic membrane, and this, in turn, is fraught with displacement of the flap and impaired engraftment.
Questions and Answers on "Perforation or rupture of the tympanic membrane"
Question:Good day! Tell me, please, there was a blow with a palm in the ear. After that, the ear was swollen, the hearing disappeared, and by the evening of the next day, they began to shoot in the ear. The ENT prescribed 7 days to make tubes of gauze soaked in otipax. He said that the rupture of the membrane from the blow. The right treatment for this?
Answer: In most cases, the membrane heals on its own. If this does not happen, surgical treatment is performed.
Question:Hello! I am 15 years old, caught a cold, sore throat, lower back, my eyes burned and periodically hurt. Suddenly, my ear ached, my aunt offered to drip Otipax, agreed. The ear began to ache even more, began to lay, the pain seemed to begin to be transferred to the healthy ear (left). The ear pain overlapped the sore throat. Before the otipax, the temperature was brought down from 37.5 to 36.6, after which it rose again to 37.5. I have a high pain threshold, I rarely cry from pain, but here I want to cry bitterly. What to do? I came to Moscow for a short time, back in two weeks. I do not know what to do. Help me please
Answer: Complications are possible, so you need a VERY Laura consultation for the examination.
Question:Hello, I'm 43. My lymph node behind my ear became inflamed and it was painful to chew. The doctor sent me to the Laura. Lor said that there is a cork that needs to be rinsed. I washed it, it hurt a lot. Feeling that water is passing through the gland. Then I reached into my ear with a pin and made it very painful, I already jerked. She laid the turunda with Vishnevsky ointment, said to pull it out the next morning. After that, the ear became deaf and began to hurt. I dripped Otipax - a terrible pain. Dropped 3 times. I went to another doctor, he said a hole in the ear, prescribed a combination to drip for 10 days. About that maybe zarosti did not say anything. And maxillofacial prescribed Tsifran antibiotics. And now I can't hear.
Answer: Hello. As a rule, perforation of the eardrum is not a threat to health and heals on its own within a few weeks. If this does not happen, they do a simple operation. See the doctor who diagnosed you with a ruptured membrane.
Question:My daughter is 3 years 11 months old. During the examination, the doctor diagnosed bilateral exudative otitis media, after 2 days he turned into acute otitis media with a temperature of 38.5 and acute pain. The doctor said during the morning examination that on the right the pre-perforative stage and by the evening the eardrum can break. Prescribed treatment: before the breakthrough - otipax. After the breakthrough - hydrogen peroxide and dioxidine. On Sunday morning, it seemed to me that the ear was leaking, but I was not sure of it. To make sure of the breakthrough, they showed themselves to the duty lore. She said there is no breakthrough, keep dripping Otipax. Five days after that, we dripped Otipax. And at the next appointment with his ENT, who gave the primary appointment, it turned out that the breakthrough was (slotted) and the ENT duty officer simply did not notice it. Now I am very worried that Otipax was dripping for 5 days with a torn eardrum. Has our auditory nerve been damaged, how can we check? What other consequences could there be? And what should we do now?
Answer: Otipax can really damage the auditory nerve if there is a perforation in the eardrum, so you need to urgently contact a specialist audiologist, preferably a special audiological center - if damage to the auditory nerve has occurred, only as soon as possible started treatment can negate the consequences of damage. If you fail to break through to the audiology center, contact the largest available ENT department of the children's hospital.
Question:Hello! I am 55 years old, I had right exudative otitis media, as a result of which I underwent paracentesis of the eardrum. A month has passed, and the hole in the ear still remains, tk. I freely blow air through my ear with my nose, very carefully, as the doctor told me. Will my eardrum get overgrown? Please advise how to help your ear, because it is lagging all the time. Thanks.
Answer: Hello! By this time, the membrane should have already overgrown. Have you written Is there a discharge from the ear? And what did the doctor prescribe for you after the operation? I strongly recommend that you contact your doctor so that there is no persistent perforation of the tympanic membrane.
Question:Hello. After receiving a blow with an open palm on the ear, he called an ambulance, the paramedic said that the eardrum was most likely damaged and told me to show up to the ENT the next day. He said that if there are severe pains, then OTIPAX drops should be dripped. I dripped them only 2 times, I almost climbed onto the wall. After visiting the ENT, the treatment was corrected, NORMAX was prescribed, the 2 mm perforation was delayed after a week. Now, a month and a half after the membrane has healed, hearing has not completely recovered. Could this be the result of the use of "OTIPAX", which is unacceptable for perforations? Will my hearing be fully restored?
Answer: The perforation of the tympanic membrane has healed, but its elasticity may not be restored in such a short time. It may not recover at all. It is necessary to do audiometry and impedance measurements to check the condition of the membrane at the moment. A good result is given by a massage of the eardrum or physiotherapy.
Question:Hello, the child is 5 years old. He injured his ear with a cotton pad, we could not go to the hospital, since the child is on a strict diet, and there is no day hospital. We started the prescribed treatment immediately (cefazolin 0.5, cotton turunda with chlorhexidine). The child does not complain that the ear hurts, but it still bleeds. We are observed by the ENT in 2-3 days. Please tell me what to do?
Answer: In fact, you have already done everything and did everything right - you turned to an ENT doctor, started treatment (by the way, absolutely adequate) and are regularly monitored by an ENT doctor. Since the damage is likely to be quite serious, be prepared for either daily supervision or hospitalization in order to ensure that the child is fed in the hospital in accordance with your diet. Again, be prepared for the fact that you yourself have to carry groceries for the child on a daily basis.
Question:Hello! Age - 60, diagnosis - perforation of the eardrum 4 mm as a result of an inflammatory cold process! The ENT doctor prescribed to take OTOPA within a week and the next examination in a month in order to identify a healing tendency or lack thereof. The question is - what medications are there that promote the healing of perforation? Thank you in advance!
Answer: There is a certain set of regenerating drugs that promote healing, unfortunately, I hardly have the right to list these drugs, your doctor can do it.
The eardrum is the thin skin that separates the middle ear and the ear canal. The work of a fragile barrier is to transmit sounds (vibration) to the hammer. The vibrations pass to the auditory ossicle and reach the inner ear. A ruptured eardrum can not only cause deafness, but also infectious diseases (otitis media, etc.). Timely treatment helps to safely solve emerging health problems.
Description of the disease
When the eardrum has burst, it means that the thin skin that connects the middle ear to the ear canal is torn. In the International classification, such damage has a code S09.2. A violation of the integrity of the membrane is indicated by the obvious wounds or holes present on it.
As a result, a person experiences unpleasant aching or sharp pains in the ear. There is a noticeable unpleasant tingling sensation inside it. If the integrity of the tympanic membrane is damaged, its work is disrupted. The normal sound vibrations cease and are distorted by air vibration.
As a result, noises appear in the ears, sometimes hearing is partially lost. Symptoms depend on the cause of the septal rupture. Based on this, a specific treatment is prescribed.
Causes of ruptured membranes
The causes of ear pain as a result of a violation of the thin skin septum can be very different. For example, a traumatic rupture of the tympanic membrane after a fall, blows, etc. The main causes of septal disorders include:
At the main risk are those who clean the ears with matches, cotton swabs, knitting needles and pins. Since the eardrum is very thin, even the smallest physical impact is enough for it to rupture the septum.
Symptoms of a ruptured membrane
Sharp pain and darkening in the eyes appear as soon as the eardrum bursts. Symptoms subside over time and others appear, indicating damage to the septum in the ear:
Additional symptoms of a burst eardrum are weakness, general malaise, and some disorientation. During the examination, patients draw the doctor's attention to aching pain in the ear. This means the onset of the inflammatory process due to infection through the hole in the membrane.
How to understand that the eardrum has burst? First of all, immediately after the injury, there will be a sharp pain in the ear. It is always very unexpected and a person may even lose consciousness. After a short time, the first sensations subside. The person begins to feel a strong pulsation in the ear.
Sometimes blood or fluid starts to flow from the ears. But discharge may not appear immediately, but after a while. Some people feel air coming out of their injured ear. This is due to the fact that the inner structure of the ear is no longer protected. Symptoms of a ruptured eardrum are the same in both adults and children. In some cases, nausea and fever appear.
First aid for injuries of the tympanic membrane
As soon as there are signs of a ruptured membrane in an adult or child, there is a risk of infection penetrating into the ear. During first aid, you must not try to flush the affected organ yourself or remove blood clots or foreign bodies from it. Do not warm, dry or apply cold to your ear.
What to do if the eardrum has burst, how to provide first aid correctly? A dry sterile turunda or cotton ball is inserted into the ear, into the external auditory canal. Then a dressing is done and the patient is taken to a clinic or hospital. If a person suffers from severe pain, one tablet of paracetamol or diclofenac is given. Any shaking should be avoided while transporting the patient. He should not be thrown back or tilted his head.
Tympanic membrane injury in children
The appearance of a ruptured eardrum in a child is often a consequence of otitis media. This is an inflammatory process that affects the mucous membranes. A distinctive feature of the disease is purulent discharge. Most often, children under 3 years old suffer from otitis media.
The disease develops in stages. First, the eardrum turns red. Then pus begins to accumulate in the ear, which breaks through the thin septum and the liquid pours out. Initially, blood is present in the discharge. During otitis media, hearing decreases and pains appear in the affected ear.
Often, the result of a breakthrough is noise and ringing after a ruptured membrane. There is a feeling of dizziness, nausea and vomiting. Hearing loss can be not only partial, but complete. It is curable if the patient is admitted to the doctor in a timely manner.
As soon as there are suspicions that the child has a hole in the eardrum (there is a photo of the damage to the septum in this article), it is necessary to stop bathing so as not to soak the wound and prevent infection from entering it.
The ear is plugged with a cotton swab until the ENT examination. You can not self-medicate yourself: use drops or folk remedies. This can not only increase pain, but also cause additional complications. Treatment should only be prescribed by a doctor.
What happens if the eardrum bursts? The level of hearing loss is directly related to the size of the wound. If the hole is small, then the sound perception will be slightly reduced. In case of severe damage to the eardrum due to otitis media, for example, trauma, fractures, etc. complete deafness may occur. Infectious chronic infections against the background of the disease can provoke a long-term hearing impairment or its complete disappearance.
Otitis media treatment
How long does it take for an eardrum to heal after rupture? If the hole is small, most often the doctor is limited to observations, since the wound in most cases heals on its own. If the process is delayed, anesthetic ear drops are prescribed.
To prevent infection from entering the inside of the ear, the hole in the eardrum is closed with tissue paper. If this method does not bring a positive result, a surgical operation is prescribed. After the opening is closed, hearing returns in most cases.
With purulent otitis media, paracentesis is prescribed to prevent damage to the tympanic membrane. With the help of an insulin needle or syringe, the accumulated contents are aspirated. Then a suspension of hydrocortisone is injected with a ruptured membrane.
After that, daily procedures are carried out to remove purulent fluid. Drainage is provided and drugs are prescribed. Ear washing is carried out with a solution of furacilin or hydrogen peroxide. Then the ear canal is plugged with turunda soaked in boric alcohol, antibiotic solutions and iodinol.
Treatment of the membrane when a foreign body enters the ear
If, due to the ingress of a foreign body into the ear, the eardrum has burst, the treatment cannot be carried out on its own. No need to try to pull out the item. These attempts can cause further injury, push the foreign body deeper, or an infection may be introduced into the ear.
ENT deals with the removal of a foreign object. During the procedure, a special hook is used. The instrument is inserted into the damaged ear and pushed between the foreign body and the septum of the ear canal. Once the hook is behind the object, it engages and withdraws.
In emergency cases, if the eardrum bursts and bleeding begins, it first stops, then tampons are inserted into the ear and a bandage is applied. If mucopurulent discharge follows, then their outflow is carried out. To liquefy the dense consistency, hydrogen peroxide is poured into the ear. Then the pus is removed with a special probe, at the end of which there is a cotton wool.
After removing the discharge, antibacterial drops are poured into the ear. Antimicrobial and anti-inflammatory drugs are also used to treat a ruptured membrane. They help tissue regenerate and help to quickly cleanse wounds from infections.
If there is a minor rupture of the tympanic membrane, treatment is not particularly required. The hole closes on its own, with the formation of an inconspicuous scar. But if the septum does not heal for months, surgery will be required.
Surgery
When a large rupture of the tympanic membrane from a shock is diagnosed, treatment is performed surgically. The operation is also indicated in cases of progressive inflammatory processes, low mobility of the auditory ossicles, or hearing impairments.
To restore the membrane, myringoplasty is done first. A small piece of the temporalis muscle is cut above the ear. This is the future "patch" of the hole in the eardrum. The treatment is then carried out using a special microscope. Miniature instruments are inserted into the external auditory canal.
The eardrum is lifted up and the hole is closed with a prepared rag. It is sewn with the torn edges of the hole with self-absorbable sutures. At the end of the operation, a tampon is inserted into the ear, which is treated with antibacterial drugs. A bandage is applied and the patient is discharged home. The bandages are removed after a week.
A ruptured eardrum from a shock is treated successfully if other important hearing organs are not affected. The sutures are absorbed within 2-3 weeks. At first, painful sensations and discomfort may appear in the ears. It goes away over time. After the operation, you should not breathe out sharply with your nose and sneeze with your mouth closed.
Complications
If, after the rupture of the tympanic membrane has been sutured, the consequences of the surgical intervention do not bring a positive result in the restoration of hearing, ossiculoplasty is prescribed. During the operation, the operation of the sound-conducting system is restored.
The auditory bones are replaced with prostheses. The operation is performed under local anesthesia. In the first days after surgery, bed rest is observed.
Hearing test
If a hole in the eardrum was sutured, there are no negative consequences in most cases. But after the operation, a hearing diagnosis is necessary, during which the degree of its acuity is determined. The examination is carried out by an audiologist using an apparatus - an audiometer.
If the integrity or mobility of the ossicles is greatly affected by a ruptured eardrum, how is it treated? To restore normal sound perception, tympanoplasty is done. This operation helps to restore hearing after an injury to the eardrum that has affected other organs in the system.
Physiotherapy
When a child's eardrum has burst, complex therapy is prescribed. If the damage to the septum is minor, the doctor only monitors the patient. Additionally, physiotherapy can be prescribed. It consists of recommendations for mandatory rest and tranquility. This helps the quickest possible recovery of the membrane.
During treatment, you can not engage in active physical exercise. Special remedial gymnastics, UHF, sollux and blue light are prescribed. When the eardrums burst , during treatment, it is forbidden to take excessively hot or cold baths. Avoid places with loud music and refrain from listening to it through headphones.
Treatment with folk remedies
When a hole is found in the eardrum, the treatment should proceed under the strict supervision of a physician. At the same time, he can additionally prescribe traditional medicine as auxiliary components that have general strengthening and anti-inflammatory effects.
In order for the hole to grow in the eardrum as quickly as possible, a large amount of vitamins C is prescribed. There are many of them in sweet grapes, hawthorn tea and in rosehip broth. It helps in the treatment of plantain juice, extracts of nightshade and needles. They moisten a tampon, which is placed in the damaged ear.
In order not to have to deal with the treatment of a ruptured eardrum, it is necessary to avoid anything that can cause damage (loud music, etc.). Among the first consequences of injuries are nausea, vomiting, and hearing loss. The most serious complications are meningitis and encephalitis. In this case, the patient may receive lifelong disability or death.
The area of the eardrum is fragile and tender, so it is easy to injure this part in the ear. Most often, the violation of the integrity of the eardrum occurs during jumping into water or with frequent use of headphones, in which sound waves are greatly overestimated.
In addition, part people injure the ear tubes and the eardrum cavity while maintaining hygiene. What to do if you pierced your ear with a cotton swab or what if the membrane burst in the ear, the consequences of the formation of perforations and more, read this material.
Bursting eardrum in the ear - signs and symptoms
Eardrum separates the external passage from the middle part of the ear and is designed to transmit sound waves and various noises further to the auditory ossicles. It is covered with soft tissues that can be easily damaged by various objects or mechanical pressure.
Most of the membrane is taut and attached to the inner ear and temporal bone. In addition, the tympanic region consists of several parts:
- The outer part consists of the skin, with the help of which it is connected to the ear canal.
- Next is the middle part, consisting of fibrous tissues, consisting of two additional elements. They consist of two directions that connect closer to the center of the tympanic membrane.
- The cavity ends with a mucous part, which is considered a continuation of the tympanic cavity.
- These elements support the work of the ear membrane, and it is thanks to them that sound waves are transmitted. In addition, among the functions of the eardrum is the protection of the ear from too loud sound waves.
Sound waves are transmitted via the outer ear, to which the eardrum is connected via an auditory tube. Sound entering the outer ear is sent through the tube and reaches the membrane.
Further, noises and sounds are converted into nerve impulses and processed in the auditory ossicles. After that, the impulses are sent to the inner ear., and then into the brain. In the event of injury or violation of the integrity of the eardrum, the function of transmitting and processing sounds is impaired.
The most common causes of perforations
Among other reasons, it is often noted chemical burns, as well as inflammation in the ear organ. For example, acute or purulent inflammations severely injure the functions of the entire ear, including the integrity of the eardrum.
Another cause that causes damage to the membrane is gunshots or strong blast waves. Most often, the military and people whose professional activities are related to the shooting coaching program suffer from this nature of perforation.
Mechanical injury most often occur in everyday life, and ear injury with a cotton swab ranks first in everyday life. This happens during the dewaxing of the ears.
For the same reason, stick matches, paper clips and other sharp objects into your ears strictly prohibited... Children's games are also referred to mechanical damage. Toddlers, due to their inexperience, often stick pencils or pens into their ears.
In some cases, the integrity of the tympanic membrane is compromised in the event of trauma to the brain or skull. This can happen during a fall or strong impact.
In addition to the reasons listed above, there are several injuries that provoke the appearance of perforations in the membrane. Due to the pressure that the symptoms listed below have, a strong effect on the tympanic cavity develops.
- Often, negative pressure builds up in the outer ear when kissing on the ear. At this time, a person experiences acute pain and severe pressure, which has a negative factor on the tympanic region and middle ear.
- In the event of a blow to the outer ear with a hand or palm of a person, pressure is generated, which quickly passes into the middle ear, exerting a negative factor on the integrity of the membrane.
- In the case of sneezing with pinched sinuses, a person causes pressure in the middle ear cavity and, as a result, a negative effect on the membrane is triggered.
- When diving under water and fast diving to a significant depth.
- When the plane is taking off.
In addition to the listed signs, thermal injury. This usually occurs under prolonged exposure to high temperatures, as well as careless handling of hot objects.
All types of burns are dangerous for the health of the ears, however, chemical burns have the most negative factor. It destroys the integrity of the entire ear, and when poisonous substances enter the middle ear, a person loses the ability to hear.
However, the most common factor is the formation of inflammatory processes.... Viruses and bacteria, penetrating into the human ear organ, cause dysfunction of many elements, which provokes severe hearing impairment, a feeling of congestion, education. In more severe cases, the middle or inner ear occurs.
With this type of ear disease, dysfunction of the Eustachian tube occurs, as its conductivity is impaired. As a result, a large amount of fluid accumulates in the patient's ear, which negatively affects the eardrum.
In the presence of purulent or mucous discharge, there is constant pressure on the cavity from the inside. This causes severe pain, dizziness and nausea. With a large accumulation of secretions, the membrane ruptures.
At the same time, with a constant negative impact on the tympanic membrane, the integrity of the entire area, and in some cases only some layers, may be disrupted.
In the event of a gunshot wound, the integrity of the tympanic membrane and nearby tissues is violated.
Symptoms
With a direct violation of the integrity of the tympanic membrane, the patient experiences severe pain.
They can be firing, pulling, sharp or sharp. After some time, its intensity decreases, but it also causes severe discomfort to the patient.
Besides, the patient develops extraneous noise in the ears and head, and hearing is significantly reduced. In addition, various secretions appear, which for the most part are purulent or mucous in nature.
In case of violation of the integrity of the tympanic membrane in case of inflammation caused by viruses or bacteria, dizziness, nausea, sleep disturbances, loss of appetite occur.
If the ear is severely injured, the patient experiences a significant hearing loss. In severe cases of inflammation, the ossicles and the inner ear are impaired.
At this time, the patient complains about constant dizziness and disruption of the vestibular apparatus... As a result, the patient is often nauseous, there is pain in the temples and head, in some cases, various discharge from the sore ear appears.
In addition, when the integrity of the tympanic membrane is violated, serious complications often arise, since a large number of viruses and bacteria penetrate into the middle ear area practically without difficulty. This can cause the formation of infectious diseases, which include otitis media, labyrinthitis, mastoiditis, neuritis.
At this time, it is important to start treatment right away, as viruses can pass from the middle to the inner ear. This is the dangerously close location of the labyrinth to the brain. Viruses can cause inflammation of the meninges, as well as provoke the appearance of meningitis or acute encephalitis.
Treatment in case of a hole in the membrane
If you have a ruptured eardrum in your ear, what should you do first? This is the question that people with injuries in the middle are puzzled with.
First thing the patient must contact a medical center for diagnosis and treatment.
It is known that in almost half of cases, patients do not require specific treatment, and healing occurs on its own. However, this rule only applies to minor injuries.
If the site of the lesion occupies up to thirty percent of the entire membrane, doctors prescribe a recumbent regimen and the use of vitamins. At this time, it is forbidden to carry out any manipulations in the ear, as well as cleaning the ear canal with cotton swabs.
If the eardrum in the ear hurts, instilling drops is strictly prohibited.
In more serious cases, the doctor prescribes surgical treatment as well as tympanoplasty. During the operation, a skin flap is attached to the affected area, which should take root on the eardrum.
After the operation, the patient needs to rinse the ears with solutions that include antibiotics. Recovery operations take about three weeks.
In addition, at the time of rehabilitation, the patient needs to take a large amount of vitamin and make sure that no water gets into the ears.
Consequences of perforations
After the course of treatment and restoration of the integrity of the eardrum, you must carefully monitor your health. The rehabilitation course takes about one month.
Unfortunately, perforation of the tympanic area has certain consequences.
In the event of minor injury and minor damage, the ear may heal on its own. However, this rule only works in half the cases. Therefore, it is not advisable to hope for a positive outcome, and if severe pain in the ear develops, it is necessary to consult a doctor for diagnosis.
a) an integral membrane. b) perforation of the tympanic membrane.
In the case of more serious injuries, deep scars and salt deposits appear in the patient's ear. In this case, there is no hope for a complete recovery. Be prepared for the patient's hearing loss. In some cases, the hearing loss is minor, and in others, the patient needs to be fitted
A ruptured eardrum is a fairly common occurrence. As a result of the damage, a rupture occurs, as a result of which the person has hearing problems.
The danger of damage to the tympanic membrane is the high probability of developing otitis media. This is due to the fact that access to various infections opens up. That is why it is so important to timely detect the problem and start the treatment process.
First, let's find out the possible causes leading to the rupture of the tympanic membrane.
Causes
The main reasons for a ruptured eardrum include:
- otitis media;
- injuries, fractures;
- aerootitis;
- noise injuries.
Let's talk in more detail about each cause and find out the mechanisms of development, as well as symptoms, depending on the provoking factor.
Acute otitis media
When the infection enters the tympanic cavity, then the inflammatory process begins to develop. Most often, after a cold, when immunity decreases, and a serious pathology develops.
Otitis media is an inflammation of the middle ear
As a result of the accumulation of purulent contents and an increase in pressure, the tympanic membrane ruptures.
The infection can get through the auditory tube, and sometimes with the blood flow it can be brought in with diseases such as: tuberculosis, scarlet fever, typhus.
At the very beginning, the following symptoms appear:
- pain;
- redness;
- hearing loss;
- headache;
- temperature increase;
- nausea, vomiting;
- deterioration of the general condition.
Mechanical damage
Than only people do not clean their ears, starting from hairpins, cotton swabs and ending with matches. Damage to the tympanic membrane occurs when an object is accidentally pushed inward.
And sometimes mechanical damage occurs due to improper technique for removing a foreign body.
Patients are tormented by severe pain and discharge of a serous-bloody nature.
Noise injury
As a result of a strong noise, patients begin to be bothered by a sharp pain, noise and ringing in the ears, as well as hearing loss.
Acoustic trauma occurs due to sudden loud noise
Patients may have loss of consciousness, amnesia, and temporary or permanent hearing loss.
As you can see, the eardrum can burst for a variety of reasons, so you cannot do without the qualified help of a specialist.
Clinical picture
A puncture of the tympanic membrane is accompanied by strong painful sensations that pass over time.
After the pain subsides, the following unpleasant symptoms occur:
- sensation of tinnitus;
- discomfort and congestion;
- hearing loss;
- bloody issues.
The hole in the eardrum has its own mechanism of occurrence and manifestation:
- painful sensations. This symptom occurs as a result of an increase in the inflammatory process, but after the eardrum has burst, the discomfort disappears;
- purulent-mucous discharge indicates the presence of an inflammatory process;
- discharge of a serous-bloody nature indicates a mechanical cause leading to piercing;
- a decrease in auditory function is due to the fact that, as a result of the inflammatory process, fluid begins to accumulate in the middle ear;
- tinnitus can be both the result of an injury and a consequence of the inflammatory process;
- dizziness and disorientation in space. This is due to a violation of the vestibular apparatus;
- nausea and vomiting may be associated with damage to the auditory and vestibular apparatus;
- increased body temperature indicates an acute inflammatory process.
Diagnostic examination
The examination of the patient begins with the collection of information about the history of the disease, which is carried out through a survey.
Accurate diagnosis is the key to successful treatment!
The specialist will find out the following information:
- when the disease occurred;
- how the symptoms proceeded;
- whether research has been carried out and what are the results;
- the presence of allergic reactions and chronic pathologies.
- condition of the skin of the auricle;
- the presence of deformities or scars;
- condition of the mastoid process;
- the presence of swelling, hyperemia, or discharge;
- condition of the lymph nodes.
Otoscopy is a diagnostic procedure that allows you to assess the condition of the external auditory canal, as well as the tympanic membrane
Among other things, laboratory diagnostics are carried out, which primarily includes a complete blood count, as well as bacteriological culture of ear secretions. In the general analysis of blood, there may be an increased level of leukocytes, accelerated sedimentation of erythrocytes, as well as an increase in rods in the leukocyte formula. With regard to bacteriological research, this is an important component of the diagnostic study, as it helps to identify the pathogenic microflora, due to which the correct treatment will be prescribed.
First aid for damage to the tympanic membrane
A damaged eardrum, as mentioned above, is an open gateway for infection to enter. In this situation, you must be extremely careful. It is forbidden to do the following:
- rinsing the ear;
- self-removal of blood clots;
- tilting or tilting the head;
- applying cold.
First aid includes three main steps:
- introduction into the external auditory canal of a sterile cotton turunda or cotton ball;
- bandaging the ear;
- transportation of the patient to a specialized institution.
With severe pain, you can give the patient an analgesic drug
If the cause of the perforation was the penetration of a foreign body, then you should not self-medicate, otherwise the consequences can be serious. Such attempts more than once led to even greater injury to the organ and further penetration of infection.
Antibiotic therapy as a treatment
Antibiotics can be given in tablet form or as ear drops. This group of drugs is prescribed to avoid the further spread of the infection, as well as to subside the strongest inflammatory process in the middle ear.
Antibacterial drugs have two main actions, namely:
- bacteriostatic;
- bactericidal.
As for the bacteriostatic effect, as a result of taking such antibiotics, bacteria are not destroyed, but the process of their further reproduction is suspended, which gives a positive dynamics of treatment.
The bactericidal effect, on the other hand, leads directly to the death of the bacterial microflora.
The course of treatment with an antibacterial group of drugs, as a rule, lasts from eight to ten days, and even with a sharp improvement in the patient's condition and well-being, this period should not decrease. If you are not fully treated with antibiotics, resistance will develop, and the next time the remedy will bring absolutely no result.
Selecting an antibiotic without bacteriological culture is the same as playing the lottery, in which the probability of winning is minimal.
When treating a child, the course of antibiotic therapy may differ slightly, so do not neglect the consultation of a specialist.
A specialist will be able to check the integrity of the tympanic membrane
As for antibacterial drugs in the form of ear drops, here are some rules for their use:
- before use, the product is warmed up to the temperature of the human body. This can be done simply by holding the drops in your fist for several minutes;
- after you have instilled the ear canal, for the next few minutes the head should be left in the same thrown position;
- an alternative to instillation can be the use of cotton turundas soaked in an antibacterial agent.
Surgical intervention
As a result of perforation, the protection of the middle and inner ear is significantly reduced. It is logical that this cannot but lead to the emergence of new inflammatory processes.
The operation can restore the protective function of the eardrum. Sometimes, if the operation is not performed on time, the infectious process develops inside the skull, and all this leads to irreversible consequences, and then to death.
Indications for surgical treatment are:
- if an inflammatory process or injury has led to a violation of the integrity of the tympanic membrane;
- severe hearing impairment;
- the mobility of the auditory ossicles is impaired.
The essence of this operation is that a small piece of muscle is cut above the ear, which in the future will be the material for laying the damage.
Myringoplasty is used to restore the integrity of the tympanic membrane
Surgical intervention is carried out under the control of a microscope, with the help of which instruments are introduced into the external auditory canal. After that, the cut piece is sewn to the hole. As a result, the damage is overgrown. After this goal is achieved, a turunda with an antibiotic is introduced into the auditory canal, and a bandage is applied, which is removed no earlier than a week later.
The suture material dissolves on its own. The rehabilitation period usually lasts two to three weeks. The only thing that the patient is not recommended to take sharp and deep breaths through the nose, as well as sneeze, closing his mouth. At first, pain and slight discomfort may bother you, which will eventually disappear without a trace.
Ossiculoplasty
This surgery restores the sound-conducting apparatus. The ossicular chain is subject to reconstruction, which is carried out by means of prosthetics.
The operation is performed under local anesthesia. And in the first days after surgery, the patient is shown strict bed rest.
Audiometry is a diagnostic procedure that measures hearing acuity.
As you know, it is easier to prevent any disease than to fight it, which is why we will talk about preventive measures.
Audiometry monitors the status of auditory function
Prevention of a ruptured eardrum
The main preventive measures include the following:
- competent and timely fight against inflammatory processes of ENT pathologies;
- in case of deterioration of hearing function, immediate appeal to a specialized institution;
- gentle cleaning of the external auditory canal;
- compliance with safety rules when flying on an airplane;
- supervision of children.
Separately, I would like to clarify safety precautions during the flight, which will prevent damage:
- on the plane, you should not use sucking sweets;
- it is better to insert cotton wool into the ear;
- massage the ears;
- do not forget to open your mouth during takeoff and landing.
So, is it possible to restore the perforation of the eardrum? Yes, modern medicine can easily cope even with such serious damage to the ear. As we found out, some of the causes leading to perforation may depend on ourselves, so be careful with your body. You should not self-medicate, at the first symptoms indicating a rupture, consult a doctor immediately.
A ruptured eardrum is common in both children and adults. The membrane is the most fragile part of the human ear, therefore it is easily damaged due to various factors. Sometimes these factors are completely independent of the person's action. This pathological phenomenon leads to hearing impairment and the development of a serious inflammatory process in the ear cavity. This condition is very painful and gives a person a lot of discomfort. With the timely detection and elimination of the problem, hearing in almost all cases is restored without any consequences,
Causes
The eardrum is a thin membrane that sits in the ear and separates the outer and middle ear cavities. It is impervious to water and air, and also prevents various foreign bodies from entering the ear. The function of the eardrum is to transmit sounds to the inner ear cavity.
The causes of damage to the membrane in children and adults are different. Most often, damage to this structure occurs due to such negative factors:
- Inflammatory process in the ear cavity. Quite often, with ear inflammation, which is accompanied by pain, people do not rush to the doctor. Due to this, exudate and pus gradually accumulate in the ear cavity, which not only exerts strong pressure on the membrane, but also corrodes it. If the disease is not treated for a long time, then after a while its rupture may occur.
- Increased pressure inside the ear cavity. Sneezing with a closed nose can lead to this. Particularly cultured people, trying to soften the sound of sneezing, cover their nose with their fingers, this leads to increased pressure inside the ear cavity. This situation occurs when an airplane takes off or a sharp dive under water.
- A very loud sound can also rupture the ear membrane. This often happens during an explosion, which not only produces a loud sound, but also increases the air pressure.
- Injuries. The reason for damage to the membrane can be hygienic procedures carried out with cotton swabs and other piercing objects. For example, some people like to use hairpins, matches, and knitting needles to remove wax from their ears, thereby increasing the risk of injury. In young children, injuries often occur during play, when they put various objects in their ears.
- Thermal impact. The eardrum can also burst if exposed to heat. This is common in fires and is also seen in people who work at elevated temperatures, such as metallurgists.
- Accidental ingestion of foreign objects in the ear can also cause inflammation and further damage to the membrane. This can also be the case if a piece of cotton wool got into the ear during hygiene procedures. In a small child, this condition may be the result of games.
- Traumatic brain injury can lead to rupture, especially in cases where a person's temporal bone is damaged.
A person should be very careful with the organs of hearing. It must be remembered that the hearing aid is very delicate and sensitive, so it is very easy to injure it.
It is only necessary to clean the auditory canals with cotton filaments. Cotton swabs should only be used to clean the outer ear.
How to understand that the eardrum has burst
Damage to the tympanic membrane is always accompanied by severe pain... Often, painful sensations are such that a person's eyes darken and consciousness becomes cloudy. After a couple of hours, the pain begins to subside, but the victim is faced with other signs of damage.
The main symptoms of damage to the tympanic membrane in humans are the following pathological conditions:
- Hearing impairment. After a while, after the pain subsides, the person begins to understand that his hearing has become worse.
- Extraneous tinnitus. This pathological condition is observed when the membrane is damaged as soon as the pain subsides a little. The ringing immediately after the rupture of the eardrum becomes more and more pronounced, and it is not possible to eliminate it.
- There is severe congestion in the ears.
- If the damage has also affected the auditory ossicles, then there is a violation of the vestibular apparatus. The person loses coordination and becomes distracted.
If the membrane bursts, then many victims note that when blowing out the nose, air seems to come out of the sore ear. This phenomenon is observed due to the structural features of the nasopharynx, where all ENT organs are directly connected.
If the cause of the injury to the auditory organ is a loud explosion or the membrane is torn from a strong blow, blood begins to flow from the ear. This always indicates a more serious degree of tissue damage.
If you experience acute pain in one ear or two at once, it is necessary to urgently consult a doctor. It is impossible to delay contacting a specialist, as the inflammatory process will spread further and affect healthy tissues. If the inflammatory process spreads to the inner ear, then this is fraught with serious consequences.
The symptoms of a damaged eardrum will depend on what caused this pathology. Depending on this, the treatment regimen is also determined.
Diagnostics
If you suspect damage to the drum membrane, you should immediately consult a doctor. This problem is dealt with by an otolaryngologist or traumatologist, but if there are no such specialists in the clinic for some reason, you need to contact a therapist.
Not in all cases, the doctor can determine the damage only after a visual examination of the patient and palpation of the sore ear. Many patients after such traumas are in a state of shock, they cannot properly explain what exactly happened and how they feel. The integrity of the membrane is determined using a special instrument that carefully examines the auditory canal. The main purpose of this examination is to determine the degree of damage to the membrane and the presence of pus or blood in the canal.
With the help of an otoscope, the doctor examines the inside of the ear, determines the degree of prevalence of the pathological process. After that, the consequences of such an injury are assessed. The doctor checks how much the patient's hearing has decreased. To do this, they often resort to audiometry, which helps determine the level of hearing. Audiometry is performed only by an ENT doctor, it is impossible to check hearing in the traumatology department, since there is no special equipment there.
For an accurate diagnosis, it is necessary to take a number of tests from the patient. A clinical blood test allows you to determine how strong the inflammatory process is in the body. An analysis of the fluid flowing from the ear can help determine which pathogens are in the ear cavity. This allows you to prescribe medications as accurately as possible.
Only after a complete examination of the patient, the doctor makes an accurate diagnosis and prescribes the appropriate treatment.
Effects
A ruptured eardrum can have serious consequences, depending on how quickly the diagnosis is made and how treatment is prescribed. The main problem is that the middle ear is not protected by anything and infections can easily enter the ear canal, provoking severe inflammation. Quite often, a labyrinthitis develops against the background of a damaged membrane. This disease is manifested by severe dizziness, nausea and vomiting. The patient's coordination is impaired. In addition, otitis media and neuritis of the auditory nerve may develop, in which a person feels severe pain.
If treatment is not taken for a long time, the infection can spread to the lining of the brain. In this case, meningitis or encephalitis develops. Both of these diseases are quite dangerous and can be fatal.
In cases where the damage to the membrane is very extensive, surgery may be required. At the same time, it is highly likely that hearing will not be fully restored and the quality of human life will significantly deteriorate.
To prevent serious complications, you should see a doctor at the first signs of injury. This will allow you to start treatment in a timely manner.
Treatment features
If the injury is not very extensive, then the membrane heals on its own, after a while. For this to happen without any complications, the patient is advised to maintain complete rest and not clean the sore ear during the recovery phase.
If the eardrum has burst, then the doctor may recommend a conservative and surgical method of treatment. The choice depends on the degree of injury and the type of injury.
Conservative treatment
In case of minor damage, the doctor applies a special patch made of special thin paper to the damaged membrane. It prevents germs from entering the middle ear cavity and speeds up recovery. You need to change such a patch every couple of days, the manipulation is carried out in compliance with the rules of antiseptics. In total, about 4 procedures are needed until complete recovery.
If there are blood clots and particles of pus in the ear cavity, then the doctor carefully removes them with a cotton flagella, and then treats the ear canal with medical alcohol. This is necessary in order to disinfect the wound and prevent the development of the inflammatory process. After processing the auditory canal, a dry cotton flagellum is inserted into it.
To avoid complications, the patient is prescribed broad-spectrum antibacterial drugs. They are especially necessary if more than a day has passed from the moment of injury to going to the doctor. Antibiotics are also needed when the victim has a fever.
Sometimes the doctor treats the edges of the wound with a solution of silver nitrate or chromic acid. In this case, the edges are only slightly wetted. It is strictly forbidden to bury such solutions in the ear!
Surgical method
If conservative treatment is ineffective or the rupture of the membrane is too large and looks intimidating, they resort to surgical intervention. Myringoplasty is performed in the following sequence:
- The operation is performed under general anesthesia, since the pain is quite severe, and even a person with a high pain threshold cannot bear it.
- The doctor makes a small incision behind the patient's ear and takes a piece of skin, which is then used to repair the eardrum.
- After that, a piece of skin is carefully sewn to the membrane with special threads, which then dissolve themselves.
- After the operation is completed, cotton wool soaked in an antibiotic solution is placed in the ear canal. This is to prevent infection.
After the restoration of the eardrum, the patient needs to refrain from deep inhalation and exhalation through the nose for some time, as this can lead to displacement of the patch.
The prognosis after the operation is quite good. In many cases, hearing can be restored almost in full. The only exceptions are cases when a person asked for help too late, and the infection has affected too large areas of tissue.
Preventive measures
Any disease is always easier to prevent than to cure later. Therefore, you need to know the basic rules that will help prevent a ruptured eardrum.
- You cannot fly in airplanes and dive into the water at a time when any ENT diseases are aggravated.
- The ear canals should not be cleaned with hairpins or other sharp objects. You can use ear sticks only when cleaning the external auditory canal and auricle.
- It is necessary to start treating otitis media as soon as the first symptoms of the disease appear.
- Loud noise should be avoided. If the work activity is associated with increased noise, personal protective equipment should be used.
- When the plane takes off, you need to dissolve the lollipop or cover your ears with headphones.
It is strictly forbidden to self-medicate for pathologies of the auditory organs. Not all people know that many ear drops are prohibited during otitis media. A qualified doctor should prescribe treatment, otherwise the consequences can be unpredictable.
If the tympanic membrane is damaged, the doctor prescribes a number of fortifying drugs that support the immune system and promote rapid recovery.
Traditional methods
Treatment can be supplemented with alternative methods. Such recipes have a tonic effect and accelerate recovery. To speed up the regeneration of damaged tissues, you should consume more products rich in vitamin C. These include fresh vegetables and fruits, berries, and sauerkraut. In addition, the patient is advised to drink rosehip broth, grape juice and tea with the addition of hawthorn.
At the stage of recovery, a cotton turunda dipped in an infusion of nightshade or pine needles can be placed in the auditory canal. All procedures must be agreed with the attending physician.
A ruptured eardrum should be treated as early as possible. Only in this case it is possible to avoid serious complications, which include labyrinthitis and meningitis. Treatment can be carried out both conservatively and surgically. Therapy is always complemented by the intake of antibacterial drugs.
Loading ...