Rupture of the tympanic membrane is a mechanical damage to the thin tissue that separates the auditory canal and the middle ear. As a result of such an injury, a person can lose all or part of his hearing. In addition, without natural protection, the middle ear remains vulnerable to infections and other physical damage. Typically, a hole or tear in the eardrum heals on its own within a few weeks and no treatment is needed. In difficult cases, doctors prescribe special procedures or surgery to ensure normal wound healing.
Symptoms
Signs of a ruptured eardrum are as follows:
- Ear pain that can come on and off abruptly.
- Clear, purulent or bloody discharge from the ear.
- Hearing loss.
- Ringing in the ear (tinnitus).
- Dizziness (vertigo).
- Nausea or vomiting as a result of dizziness.
When to see a doctor
Sign up for a consultation at a clinic or centerhe alth care services if you have characteristic symptoms of a ruptured or minor injury to your eardrum, or if you experience pain or discomfort in your ears. The middle ear, like the inner ear, consists of very fragile fragments and is vulnerable to disease and injury. Timely and adequate treatment is of paramount importance for the preservation of normal hearing.
Reasons
The main causes of a ruptured eardrum can be summarized as follows:
- Infection of the middle ear (otitis). As a result of an infection, fluid builds up in the middle ear, which puts excessive pressure on the eardrum and thereby damages it.
- Barotrauma is an injury resulting from a strong tension of thin tissue, provoked by a pressure difference in the middle ear and in the environment. Too much pressure can rupture the eardrum. Closely related to barotrauma is the so-called stuffy ear syndrome, which affects almost all air passengers. Pressure drops are also characteristic of scuba diving. In addition, any direct blow to the ear is potentially dangerous, even if such a blow came from a deployed airbag in a car.
- Low sounds and explosions (acoustic trauma). A rupture of the eardrum, the symptoms of which will be obvious in the blink of an eye, often occurs under the influence of excessively loud sounds (explosions, shooting). An excessively powerful sound wave can seriously damage the delicate structureears.
- Foreign objects in the ear. Small objects like a Q-tip or hairpins can pierce and even rupture the eardrum.
- Severe head injury. Traumatic brain injuries cause dislocation and damage to the structure of the middle and inner ear, including tympanic membrane rupture. A blow to the head can crack the skull, it is this circumstance that most often serves as a prerequisite for a breakthrough in thin tissue.
Complications
The eardrum has two main functions:
- Rumor. When sound waves hit the eardrum, it begins to vibrate. Structures in the middle and inner ear sense these vibrations and translate sound waves into nerve impulses.
- Protection. The eardrum also acts as a natural protective barrier, keeping water, bacteria, and other foreign matter out of the middle ear.
In trauma, complications can occur both during the healing process and if the eardrum fails to heal completely. Potentially Possible:
- Hearing loss. As a rule, hearing disappears only for a while, until the hole in the eardrum disappears on its own. However, many patients of otorhinolaryngologists note a noticeable decrease in the quality of hearing even after the breakthrough has completely healed. Much depends on the location and size of the wound.
- Infection of the middle ear (otitis). A ruptured eardrum in a child or adult makes it easier for bacteria to enter the ear canal. If athe tissue will not heal on its own and the patient will not seek medical attention, there is a high risk of developing untreatable (chronic) infectious diseases, which can eventually lead to complete hearing loss.
- Middle ear cyst (cholesteatoma). Cholesteatoma, or pearl tumor, is a cyst composed of skin cells and necrotic tissue. If the eardrum is damaged, dead skin cells and other debris can get into the middle ear and form a cyst. Cholesteatoma provides a breeding ground for harmful bacteria and contains proteins that can weaken the bones of the middle ear.
Before visiting the doctor
When you think you've had a ruptured eardrum, the symptoms are a relatively accurate indication of an injury. If the quality of hearing has noticeably decreased, sign up for a consultation with a specialist. You can visit a therapist first, but to save time, it is recommended to immediately go to an appointment with an otorhinolaryngologist.
Before visiting a specialist, it is advisable to think about what you are going to tell about your illness. In order not to forget anything, fix the key information in writing. Please describe in detail:
- symptoms that bother you, including those that you think are not eardrum damage or hearing loss, watery discharge, or other typical signs of trauma;
- recent incidents in your life that could be the reasonear injuries, including infectious diseases, sports injuries, air travel;
- drugs, including vitamin/mineral complexes and dietary supplements you are currently taking;
- questions to ask your doctor.
If you suspect a ruptured eardrum due to otitis media or from a stroke, consider asking your otolaryngologist the following questions:
- Is my eardrum ruptured?
- If not, why did I have hearing loss and other symptoms?
- If my eardrum is damaged, what should I do to protect my ear from possible infections during its natural healing process?
- Do I need to make another appointment to have you check how well the tissue has healed?
- When should specific treatments be considered?
Feel free to ask other questions to the specialist.
What the doctor will say
The otorhinolaryngologist, in turn, will ask the following:
- When did you first notice symptoms of injury?
- Rupture of the eardrum is often accompanied by pain and characteristic dizziness. Have you noticed similar signs of tissue damage in yourself? How fast did they go?
- Have you ever had an ear infection?
- Have you been exposed to excessively loudsounds?
- Have you swum in a natural body of water or in a pool lately? Did you scuba dive?
- Have you traveled by plane lately?
- When was the last time you had a head injury?
- How do you clean your ears? Do you use any items for cleaning?
Before consultation
If the appointment time with the otorhinolaryngologist has not yet arrived, and you suspect a rupture of the eardrum from a blow, you should not start treatment on your own initiative. It is better to take all possible measures to prevent infectious diseases of the ear. Try to keep your ears clean and dry, refrain from swimming, and make sure that water does not get inside the ear while bathing or showering. To protect your damaged ear while swimming, insert elastic waterproof silicone earplugs or a cotton ball soaked in petroleum jelly every time.
Do not use any self-purchased ear drops; medicines can only be prescribed by a doctor and only for the treatment of infectious diseases associated with damage to the eardrum.
Diagnosis
To determine the presence and extent of damage, the ENT usually examines the ear visually using a special illuminated instrument called an otoscope. If it is not possible to accurately determine the cause or extent of the rupture during a superficial examination, the doctor may prescribe additionaldiagnostic tests, including:
- Laboratory tests. If you notice a discharge from an injured ear, the otolaryngologist will likely order a laboratory test or culture of a sample of the discharge to determine the type of infection affecting the middle ear.
- Assessment of hearing with a tuning fork. Tuning forks are two-pronged metal instruments that make a sound when struck. A simple examination with their help will allow the doctor to diagnose hearing loss. In addition, the use of a tuning fork allows you to determine what caused the hearing loss: damage to the vibrating parts of the middle ear (including the eardrum), injury to the receptors or nerves of the inner ear, or both.
- Tympanometry. A tympanometer is a device placed in the ear canal to evaluate the response of the eardrum to slight changes in air pressure. Certain reaction patterns may indicate a ruptured tympanic membrane, the symptoms of which, in some cases, do not even cause much concern to the patient.
- Audiological examination. If other tests and analyzes have not yielded significant results, the doctor will prescribe an audiological examination, which means a series of strictly verified tests conducted in a soundproof booth to assess the patient's perception of sounds of different volumes and at different frequencies.
Treatment
If you are diagnosed with a normal, uncomplicated eardrum rupture, the consequences are likely to be most favorable: in the worst case, youexpects only a slight deterioration in hearing on the affected side. If there are signs of infection, the doctor will prescribe an antibiotic in the form of ear drops (Otipax, Sofradex, Otinum). If the break does not heal on its own, you may need to resort to special procedures to ensure complete healing of the eardrum. ENT may prescribe:
- The application of a special patch to the eardrum. This is a fairly simple procedure in which the doctor treats the edges of the gap with a substance that stimulates cell growth, and seals the damage with a special material that serves as a kind of plaster for the injured tissue. You will likely have to repeat this action several times before the eardrum is completely healed.
- Surgical operation. If the patch does not help, or if your doctor seriously doubts that a simple procedure will heal a ruptured eardrum, he will recommend surgical treatment. The most common operation is called tympanoplasty. The surgeon will make an incision above the ear, remove a tiny piece of tissue, and use it to close the tear in the eardrum. This is a simple operation and most patients return home the same day.
At home
It is not always necessary to contact a specialist for medical advice and diagnosis. For many people diagnosed with a ruptured eardrum, treatment is only protectioninjured ear from new injuries and in the prevention of possible infections. The self-healing process takes several weeks. Regardless of whether you have turned to an otolaryngologist or not, take all possible measures to protect the damaged ear from complications. Doctors recommend following these rules:
- Keep your ear dry. Insert waterproof silicone earplugs or a cotton ball soaked in petroleum jelly into your outer ear every time you bathe or shower.
- Refrain from brushing. Do not use any substances or objects to clean your ears, even if they are specifically designed for this purpose. Give your eardrum time to heal completely.
- Don't blow your nose. The pressure generated by blowing your nose can damage already injured tissue.
Prevention
To prevent a ruptured eardrum, follow these guidelines:
- treat middle ear infections promptly;
- Protect your ears when traveling by air;
- avoid cleaning your ears with foreign objects, including cotton swabs and paper clips;
- wear headphones or ear plugs if your job involves excessively loud noise.
Following these simple tips will protect your eardrums from damage.
