Tympanic membrane perforation

Tympanic membrane perforation

1. tympanic membrane Perforation

2. Etiology Direct force Careless while removal wax by himself or herself Skull fracture may tear TM Hot slag fly into the ear Indirect force Increase in violence and firearms Barotrauma

3. Associated complications Is usually associated with TM or inner ear trauma unless Iatrogenic Ossicular discontinuity Facial Nerve Injury Chorda tympani Nerve Injury Barotrauma to Stapes footplate

4. Clinical manifestations Otalgia Bleeding Fullness Hearing loss: conductive HL or mixed HL Tinnitus Shape of perforation is split

5. Physical examination Tympanic perforation Central perforation Marginal perforation Blood crust If skull base fracture is occurred with CSF leakage, clear fluid is observed.

6. Diagnosis Otoscopic examination The audiometry can provide useful informations . Conductive Hearing loss > 40db suspicion for ossicular discontinuity Hearing test reveals sensori -neural Hearing Loss, it means inner ear injury

7. Management Antibiotic to prevent infection Aseptic external auditory canal with alcohol Prevent super respiratory infection Prohibit nasal blow Prohibit ear drops It takes 3-4 weeks to heal the ear drum If 3 months later, perforation still exists, myringoplasty is indicated.

8. Preventions Be caution while removing your wax Using ear plug

9. The End