Difference between revisions of "Tympanic membrane rupture"

(See Also)
(Background)
 
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==Background==
 
==Background==
 +
[[File:Gray907.png|thumb|Ear anatomy]]
 
===Causes===
 
===Causes===
 
*Blunt trauma (hand blow to ear, fall, direct hit)
 
*Blunt trauma (hand blow to ear, fall, direct hit)

Latest revision as of 02:16, 16 August 2019

Background

Ear anatomy

Causes

  • Blunt trauma (hand blow to ear, fall, direct hit)
  • Penetrating trauma (Q-tip, matchstick, gunshot wound, welding spark)
  • Direct ear trauma
  • Lightning strike
  • Barotrauma

Clinical Features

Smaller perforation
Larger perforation (acute)
Larger perforation (chronic)
  • Ear pain
  • History of barotrauma or direct ear trauma

Differential Diagnosis

Ear Diagnoses

External

Internal

Inner/vestibular

Evaluation

  • Typically clinical

Management

  • Isolated small tympanic membrane perforations
    • Antibiotic ear drops for contaminated wounds - ciprofloxacin suspension (more appropriately viscous than solution)
    • Water precautions (keeping water out of the middle ear), avoid forceful Valsalva
    • Reevaluation with PCM, typical healing within 4-6 weeks
  • In children after TM perforation due to otitis media, PO antibiotics preferred over topical
  • Significant hearing loss (≥40 dB), vertigo, nystagmus, ataxia, facial nerve injury, large perforation with folded over edges, prolonged healing
    • Urgent evaluation by ENT

Disposition

  • Outpatient management

See Also

References