ENT

Perforated Eardrum

A tympanic-membrane perforation is a hole caused most often by acute otitis media, direct trauma or pressure change; most heal spontaneously, so keep the ear dry, avoid instrumentation and unprescribed drops, and refer persistent, infected or complicated perforations.

Definition

A perforated eardrum is a full-thickness defect in the tympanic membrane. It may be acute after infection, trauma or pressure change, or chronic with ongoing middle-ear disease; marginal and attic disease needs particular attention because of the risk of cholesteatoma.

First principles

The defect causes conductive hearing loss and opens the middle ear to water

The tympanic membrane transmits sound and helps protect the middle ear. A hole reduces sound transmission and can allow water or bacteria into the middle ear, causing discharge or recurrent infection; a sensorineural component suggests additional inner-ear or temporal-bone injury.

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