Drops in the ears with a perforated eardrum. How to treat perforation of the eardrum: drops or surgery. Common causes of membrane rupture

Violation of the integrity of the tympanic membrane entails the spread of infection in the middle ear, and if an acute form of otitis media is diagnosed, then it is necessary to carry out complex therapy with the following drugs:

analgesics - the removal of pain after an injury;
broad-spectrum antibiotics - localization of the inflammatory process;
mucolytic agents - thinning of mucus;
vasoconstrictor drugs - removal of puffiness and reduction of pressure on the membrane.

In the case of a small perforation (up to 25% of the entire membrane area), a specialist in a medical institution closes the gap with a paper patch. First, he processes the edges of the hole with a special tool that belongs to the group of growth stimulants, and then applies a patch. Usually the patient needs to undergo 3-4 such procedures.

During otoscopy, blood particles or dirt may be found in the ear cavity. Then the otolaryngologist removes them with a cotton swab and treats the cavity with an antiseptic for disinfection (alcohol).

At the end of the procedure, a sterile cotton wool turunda is placed in the ear for a certain time. If a small wound is found, its edges are cauterized with agents such as chromic acid and silver nitrate.

Injuries associated with a large area of membrane damage, as well as ineffective drug treatment, without fail require surgical intervention. There are the following types of operations:

myringoplasty. The surgeon makes an incision above the ear and takes a small piece of the skin of the temporalis muscle, which replaces the gap in the membrane. All this is sewn together with threads and absorbable material is applied on both sides, helping to hold the skin flap until it is completely engrafted. It takes 2-3 weeks. The operation is performed under general anesthesia;
tympanoplasty. When diagnosing impaired mobility and integrity of the auditory ossicles, they are surgically removed or replaced. Such an operation allows you to restore the normal functioning of these bone formations in the middle ear. The second stage is ossiculoplasty, which is performed under local anesthesia and consists in prosthetics of the auditory ossicles.

In the postoperative period, the patient will experience pain for some time, but this is normal, which will gradually pass.

The reasons that lead to perforation (or trauma to the eardrum) are different. These can be inflammatory processes in the ear, as well as ear injuries, including noise injury.

Causes of eardrum perforation:
1. Inflammatory process in the middle ear
. With inflammation in the middle ear - otitis media - discharge accumulates. This discharge may 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 is also subject to 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.
2.

Barotrauma, or acoustic trauma
(lat. baro - pressure). As mentioned above, if fluid accumulates on the inside of the eardrum, it can rupture. However, pressure from its outside can also cause a rupture.

This happens, for example, when an open palm is suddenly applied to the ear, sometimes a rupture of the membrane can also occur in flight during the ascent or descent of the aircraft, when 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 in this case air enters the middle ear through the Eustachian (auditory) tubes with each sip.
3.

noise injury
. A sudden loud 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, the tinnitus disappears and hearing is partially restored.
4. Foreign bodies
. Sometimes when cleaning the ear canal, for example, with a cotton swab or other objects, the eardrum can be injured. In addition, it contributes to the infection in the middle ear.

Risk Factors for Perforation of the Tympanic Membrane
Risk factors that can lead to perforation or rupture of the eardrum include:
- Accumulation of fluid in the middle ear.
- Independent cleaning of the ear from sulfur with hard objects (sticks, cotton, etc.).
– Excessive scratching of the ear due to itching in the ears.

Overview of Effective Drops for Perforated Tympanic Membrane

Drug therapy with antibacterial drops is aimed at eliminating inflammation in the ear area.

Normax

The drug is highly effective against gram-positive and gram-negative bacteria. It contains the antibiotic Norfloxacin and cellulose, talc, magnesium stearate, sodium lauryl sulfate, colloidal silicon dioxide, titanium dioxide, sodium starch glycolate.

For these reasons, such drops are prohibited during pregnancy, breastfeeding, individual sensitivity to the components of the drug and children under 15 years of age. Daily appoint 6 p. inject 2-3 drops into the ear.

Uniflox

The composition of these drops includes the antibiotic Ofloxacin as an active substance and benzahexonium chloride, disubstituted and monosubstituted sodium phosphate, water, as auxiliary components.

per day, and at an older age it increases to 10 drops every 12 hours. The course of treatment lasts 10 days for external otitis, and 2 weeks for a purulent form. In childhood, the drug is used no more than 1 week.

Tsipromed

The basis of these ear drops is the antibiotic ciprofloxacin. The excipients are sodium hydroxide, sodium chloride, benzalkonium chloride, lactic acid, sodium edetate and water.

It is also an antibacterial drug from the group of fluoroquinils. Contraindications to the appointment are identical to the above Normaks drops. With purulent otitis media aggravated by perforation, the dosage is 5 drops 3 r. in a day.

The main contraindications to the appointment of the above ear drops:

pregnancy;
lactation period;
individual sensitivity to the antibiotic that is part of the drug;
children's age up to 3 years (Uniflox) and up to 15 years (Normax and Tsipromed).

For the treatment to be effective, the following rules of instillation must be observed:

Before applying the drops, you must carefully clean the ear from dust and dirt. To do this, take a special cotton swab and moisten it in hydrogen peroxide or warm water. Then they squeeze it so that excess water does not get into the ear canal, and they clean it by several scrolls of the stick around its axis.
The bottle is heated in a bowl of hot water or held in the hands for 15 minutes to make the drops warm.
The patient is laid with his head on the pillow, with the diseased ear up.
Bring the vial dropper or pipette to the ear so as not to touch the skin. During instillation, pull the ear up and press it against the skull.
After instillation, you need to press on the tragus so that the drops penetrate deeper.
In the supine position, you need to remain for 5 minutes, and close the ear with sterile cotton to create a thermal effect.

Topical preparations will be selected by a specialist based on what exactly provoked a ruptured eardrum.

Ear drops are:

Antibacterial. These drops in the ear during perforation are prescribed if bacteria are the cause of the development of a purulent form of otitis media. Also, this type of drug is used for prophylactic purposes in order to prevent the pathogenic flora that has penetrated through the perforation from developing an inflammatory process in the tympanic cavity.
Painkillers. With such drops, the painful symptoms accompanying injuries and inflammatory processes are eliminated.
Antifungal. Drops that fight the fungus are prescribed for mycoses and as a preventive measure against the background of antibiotic therapy.
Anti-inflammatory. This type of drug is used to relieve extensive inflammation against the background of trauma and purulent processes.
Antiseptic. Disinfectant drops are included in complex therapy, if necessary, sanitation of the tympanic cavity.

In fact, there are many medications available in the form of drops designed specifically for the treatment of ear diseases. What to prescribe in each case, decides only the attending physician.

The specialist first of all justifies the course of treatment by the degree of tympanic membrane rupture, takes into account provoking factors and what additional medication can be prescribed in the case of chronic diseases of the hearing organs.

Tsipromed

The drug Tsipromed is widely used. In the treatment of ear diseases, a 0.3% solution is used. The main active ingredient is Ciprofloxacin. Three times daily it is recommended to instill such drops in the ear with perforation of the membrane. The dosage is chosen individually and usually does not exceed 5 drops for each procedure.

The drug is preliminarily kept for some time at room temperature and then instilled using a pipette, directing the substance strictly to the walls of the ear canal.

Also, this tool is used to soak a cotton swab, which must be placed in a sore ear, changing to a fresh one up to 4 times a day. Such treatment relieves painful symptoms within 48 hours.

Uniflox

To relieve pain, doctors often prescribe Uniflox ear drops. The tool is based on an antibiotic called Ofloxacin and is highly effective. The treatment lasts about 10 days, taking into account the fact that the drug is instilled in a timely manner into the sore ear, 10 drops every twelve hours.

Normax

The doctor often prescribes drugs based on the antibiotic Norfloxacin, for example, the drug Normax. The course of treatment is selected individually, but daily instilled up to 6 times a day, 2-3 drops of the drug.

Ear drops for eardrum perforation

Each of these drugs has a lot of contraindications, and only an experienced specialist can take into account and understand the possibility of their manifestation.

pregnant and lactating mothers;
allergy sufferers;
people with individual intolerance to antibiotics.

At the slightest suspicion of an injury to the eardrum, you should immediately contact an otorhinolaryngologist. Only a doctor can determine which ear drops can be used for perforation of the eardrum specifically in your case.

The specialist will need time to study your problem in depth. It is necessary to take into account the state of the anguish, the causes of the pathology. Assess the general condition of the patient, the observed symptoms. Only then will the doctor be able to prescribe the right drug.

In some cases, it may be necessary to test the tolerance of one or another active component of the selected agent in order to exclude possible side effects.

In fact, there are many medications available in the form of drops designed specifically for the treatment of ear diseases. What to prescribe in each case, decides only the attending physician.

Normax

Symptoms

A ruptured eardrum, especially at the very beginning, can be quite painful. Symptoms of tympanic membrane perforation include:
- Sharp sharp pain in the ear.
- Clear or purulent discharge from the ear with perforation of the membrane due to otitis media.

- Bloody discharge from the ear with a traumatic nature of perforation - a foreign body, direct trauma or noise trauma.
- Sudden decrease in pain when fluid breaks through the eardrum in otitis media.
- Hearing loss.
- Noise in ears.

Complications of perforation of the tympanic membrane
Usually, a rupture or perforation of the eardrum does not pose a serious threat to the patient's health and usually heals on its own within a few weeks.

But complications can still be:
– Hearing loss
. Usually this complication is temporary, and it passes through the sulfur of the healing of the rupture of the membrane. Naturally, the larger the gap, the longer it heals and the longer the hearing loss lasts.

In addition, the location of the tear or perforation also affects the degree of hearing loss. 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
(chronic otitis media). Extensive perforation of the membrane or its rupture may be accompanied by recurrent infection of the middle ear cavity, resulting in chronic inflammation. This can contribute to permanent hearing loss.

Damage to the eardrum due to trauma, as a rule, is accompanied by severe sharp pain, which subsides after a while.

After the pain subsides, the victim has the following symptoms:

noise in ears;
a feeling of discomfort of ear congestion;
bloody discharge from the external auditory canal;
hearing loss.

With a complete rupture of the eardrum, the patient, when sneezing or blowing his nose, will feel how air is released from the affected ear. Damage to the inner ear will cause dizziness.

In the event that a rupture of the tympanic membrane arose as a result of an inflammatory process, purulent-mucous discharge from the external auditory canal and fever will also be added to the symptoms.

Symptoms	The mechanism of occurrence and manifestation
Pain	In acute otitis media, pain occurs at the beginning of the disease due to the developing inflammatory process, and after perforation of the eardrum, it subsides sharply. In the event that the rupture of the tympanic membrane arose due to injury, then the appearance of sharp acute pain will be characteristic here.
Purulent mucous discharge	As a rule, this symptom indicates an inflammatory disease, as a result of which a perforation of the tympanic membrane occurred.
Serous-bloody discharge	Usually they indicate a mechanical injury, as a result of which a rupture of the eardrum occurred.
Hearing loss	It occurs due to the accumulation of a large amount of fluid in the tympanic cavity due to the resulting inflammatory process in the middle ear ( e.g. otitis media ).
Noise in ears	May occur as a result of trauma e.g. after the explosion ) and due to inflammatory disease ( e.g. in acute otitis media ). It manifests itself in the form of ringing, whistling, buzzing, roaring or hissing.
Dizziness	Occurs when the vestibular system is damaged due to a head injury or inflammation of the inner ear. Manifested by a feeling of violation of the orientation of the body in space.
Nausea	Occurs when the vestibular or auditory apparatus is affected. The cause may be acute otitis media, an acoustic ear injury, or a head injury. It manifests itself in the form of a painful sensation in the pharynx. This condition usually provokes vomiting.
Increase in body temperature	This symptom indicates an acute inflammatory process in the ear (otitis media). ). As a rule, it is accompanied by weakness, general malaise, chills. Usually, in acute otitis media, body temperature rises to 39 ° C.

Immediately after damage to the tympanic septum, a person experiences severe pain. Symptoms of tympanic membrane perforation are:

extraneous sounds in the ears;
the exit of purulent mucus from the organ, if the impulse arose as a result of otitis media;
with perforation of the eardrum due to trauma, bloody compartments may appear;
hearing loss.

In case of injury to the inner ear, the patient experiences dizziness. If the eardrum is completely torn, then air comes out of the organ of hearing. With a small injury, the signs are not pronounced. The severity depends on how damaged the organ. With a slight damage, the pain recedes quickly and hearing is only slightly reduced. With extensive trauma, the inflammatory process can go to the entire organ.

With a complete or partial perforation of the eardrum, the symptoms are determined by the degree of damage. This pathology is characterized by the following symptoms:

Severe pain in the ears (constant sign). With an injury, the pain in the ear is sharp, sharp and decreases after a while. In inflammatory diseases of the middle ear, this symptom is due to an increase in pressure in the cavity of the organ.
Noise in the ears on one or both sides. It is felt by a sick person in the form of a ringing, hum, hiss or whistle.
Dizziness. It is a sign of damage to the vestibular apparatus. It is often observed with perforation of the membrane against the background of otitis media because the accumulated pus during rupture can rush into the cavity of the inner ear.
Nausea. It is observed when the sound-perceiving apparatus is damaged. Often associated with vomiting.
Mucopurulent discharge.
Increase in body temperature. It is observed when the marginal perforation of the membrane arose against the background of purulent otitis media.
Deafness (hearing loss). Most often it is unilateral.
Weakness.
General malaise.

When perforated, the ear is often blocked. With self-identified symptoms of damage to the tympanic membrane, you should consult a doctor.

extraneous sounds in the ears;
the exit of purulent mucus from the organ, if the impulse arose as a result of otitis media;
with perforation of the eardrum due to trauma, bloody compartments may appear;
hearing loss.

The severity depends on how damaged the organ. With a slight damage, the pain recedes quickly and hearing is only slightly reduced. With extensive trauma, the inflammatory process can go to the entire organ.

Some injuries are minor and the injured person does not always consider it necessary to visit a doctor. There are cases when small damage to the eardrum passed almost without a trace. However, in other cases, damage is characterized by the following symptoms:

sharp and sharp pain in the ear canal;
sharp;
aching sensations inside the ear canal;
ear congestion;
discharge;
the appearance of a small amount of blood.

The intensity of the manifestation of symptoms depends entirely on the degree of complexity of the injury. So, the victim may show only a couple of symptoms that will not be particularly disturbing.

In some cases, damage to the eardrum can be so severe that people are in pain.

Perforation of the tympanic membrane cannot occur unnoticed. After a rupture in the ear, severe discomfort occurs. The symptoms of a ruptured eardrum are as follows:

sharp pain in the damaged ear;
noise, cotton;
the appearance of copious discharge (with inflammation);
dizziness;
hearing loss.

To reliably find out if the eardrum is damaged, you need to contact an otolaryngologist. The doctor will identify the degree and cause of the perforation, prescribe drops and tablets to restore the integrity of the ear.

Diagnostics is as follows:

Otoscopy. Examination of the ear with an otoscope. The perforation of the tympanic membrane itself is revealed, and other prerequisites and consequences of damage.
Otomicroscopy. It is carried out in order to examine the ear in more detail and find out additional signs of the presence of perforation of the eardrum, its severity and nuances of the problem.
Audiometry. Since the violation of the integrity of the eardrum is associated with hearing loss, these symptoms can be confirmed by studying the sensitivity of sound perception. For the child, special studies of sound potentials are carried out.
Impedancemetry. The ear is examined through computer tests.
Tympanometry. After damage to the ear, it is necessary to check the sensitivity of the membrane.
Cameron tests. The ear has the ability to carry out bone conduction of sound.

If the provoking factor was an injury, additional examinations may be needed: X-ray, CT, MRI.

After identifying the severity of the problem and the factors that provoked it, a special course of treatment is prescribed. This may include ear and nasal drops, plastic, physiotherapy, etc. It is important to take care of the diseased ear until complete recovery.

Diagnostics

In order to determine damage to the tympanic septum in adults and children, you will need:

collecting an anamnesis of life and an anamnesis of the disease;
otoscopy (external examination of the membrane and outer ear);
microotoscopy (examination with a magnifying device);
palpation;
general blood analysis;
study of the ability of an organ to conduct sound;
CT scan;
bacteriological examination of the secret;
radiography.

To determine the possible causes of perforation, the condition of the mucous membranes of the nose, oral cavity, pharynx and larynx is assessed. For this purpose, rhinoscopy, pharyngoscopy and laryngoscopy are carried out. The simplest method of examination is an examination of the organ of hearing.

When perforation is determined: a slit-like defect or a rounded hole in the membrane, purulent masses, tissue swelling and redness. In severe cases, there are signs of damage to the internal muscles of the tympanic cavity.

Otoscopy is performed to diagnose perforation of the membrane.
. To do this, the doctor inserts a metal or plastic funnel into the ear. Next, the patient's auricle is pulled up and back. This technique allows, as it were, to align the course of the auditory canal, as a result, the tympanic membrane becomes visible at its end.

Light is directed into the ear canal. Perforation marks a hole in the eardrum. When it breaks, the auditory ossicles of the middle ear can even be seen. In addition, depending on the cause of the tear or perforation, there may be blood or pus in the ear canal.

Collection of anamnesis

An examination by an ENT doctor begins with a conversation during which the doctor collects an anamnesis. Anamnesis is a collection of information about the patient, which the doctor receives by questioning the latter.

There are the following types of anamnesis:

passport data
where the doctor finds out from the patient his last name, first name and patronymic, as well as the availability of an insurance policy;
medical history
, in which the doctor is interested in the date of the onset of the disease, the development of symptoms, as well as the results of the studies, if any;
anamnesis of life
when the doctor asks about previous diseases, and is also interested in the patient's living conditions and the presence of bad habits;
family history
where the doctor finds out if the patient's relatives have diseases that can be inherited;
allergic history
, in which the doctor is interested in whether the patient has allergic reactions to any allergens, for example, foods, drugs, plants.

Collecting an anamnesis from the patient, the ENT doctor is interested in the existing chronic diseases of the ear, nose and paranasal sinuses, which can provoke damage to the eardrum (

). Also, for the ENT doctor, information regarding the operations on the ENT organs, bad habits and working conditions of the patient is important.

After collecting an anamnesis, the doctor proceeds to an external examination and palpation of the ear.

Before conducting an external examination, the patient is seated so that his legs are located outward from the instrument table, while the legs of the doctor should be between the patient and the table.

Then the light source is installed in the form of a table lamp. The lamp should be located to the right of the patient and at a distance of ten to fifteen centimeters from the auricle. After installing the light source, the ENT doctor turns the patient's head to the side and proceeds to the external examination of the ear. The healthy organ is always examined first.

Usually, an external examination of the ear is performed in combination with a palpation examination, in which the consistency, volume, and soreness of the tissues are determined in places of pathological changes.

The doctor should palpate with clean and warm hands, with the utmost care. It is forbidden to intentionally cause severe pain to the patient, even for diagnostic purposes.

External examination and palpation of the ear allow:

assess the condition of the skin of the auricle;
identify deformity of the auricle;
identify the presence of scars behind the ear area;
assess the condition of the mastoid process;
detect swelling and hyperemia in the area of the mastoid process;
detect discharge from the ear of a different nature;
identify violations of facial muscles in case of damage to the facial nerve;
determine the enlargement of nearby lymph nodes;
detect postoperative scars;
determine the state of the entrance to the external auditory meatus.

Normally, the following indicators are determined:

the skin of the auricle is pale pink;
the relief of the auricle is pronounced;
there are no scars behind the ear area;
on palpation, painlessness of the tragus and mastoid process is noted;
free and wide ear canal.

After external examination and palpation, otoscopy is performed.

Otoscopy

Otoscopy is a diagnostic procedure that examines the external auditory canal and the eardrum. With extensive perforation of the tympanic membrane, otoscopy can also be performed in the tympanic cavity. As a rule, the study is carried out using an ear funnel and a frontal reflector.

Instruments for otoscopy	Description	A photo
ear funnel	A cone-shaped device that is used to examine the deep part of the external auditory canal and the tympanic membrane. Exist: plastic (disposable) ) ear funnels; reusable metal ear funnels. There are various sizes.
forehead reflector	Special ENT instrument in the form of a rigid hoop and a round mirror with a hole for the eye. Before examining the ENT organs, the doctor puts this device on his head and lowers the mirror so that he can observe what is happening through the hole. The frontal reflector reflects the illumination of the lamp and directs the light into the cavity of the organ under study.
Otoscope	An endoscopic device that is used in modern medicine. Designed for the diagnosis and treatment of diseases of the external auditory canal and tympanic membrane. Consists of the following parts: funnel expander; lens system; built-in light source.

Before inserting the ear funnel, the ENT doctor pulls the patient's auricle upwards and backwards in order to straighten the ear canal. For small children, the ear is pulled down.

Before performing an otoscopy, the ENT doctor lowers the forehead reflector, pulls the patient's auricle with his left hand, and gently inserts the ear funnel into the ear with his right hand.

When examining, the ENT doctor, first of all, pays attention to the presence of identification points of the tympanic membrane.

There are the following identification points of the tympanic membrane:

hammer handle
;
short malleus
in the form of a yellowish-white protrusion the size of a pinhead;
light reflex
, which occurs when the light rays incident from the reflector are reflected;
anterior and posterior malleus folds
in the form of grayish-white stripes.

The color and position of the eardrum is also important. Normally, its color is mother-of-pearl gray, and with various inflammatory diseases, its redness is noted. The pathological position of the tympanic membrane is characterized by its excessive retraction or swelling.

Tympanic membrane perforations are of two types:

rim
, at which the preservation of tissues in the area of the tympanic ring is observed;
regional
, in which all tissues of the tympanic membrane are affected to the bone.

the size of the damaged area;
perforation shape;
the nature of the edges;
square localization.

To detail the pathological process during otoscopy, the tympanic membrane is conditionally divided into four segments - anterior superior, anterior inferior, posterior superior, posterior inferior.

With a small damage to the eardrum, minor pathological changes in the ear are usually observed. This may be a vascular lesion in the area of the handle of the malleus, accompanied by pain, bruising and minor bleeding from the ear.

Also, perforation of the eardrum is usually accompanied by discharge from the ear. The appearance of exudation indicates an existing inflammatory process in the ear, as a result of which the tympanic membrane may have ruptured.

When pus is released from the ear, exudate is taken (using a special loop
) for subsequent bacteriological examination. Bloody discharge from the ear, as a rule, indicates that the perforation of the eardrum has occurred due to trauma.

bacteriological examination of exudate.

an increase in white blood cells (leukocytosis
);
accelerated ESR ( sedimentation rate of erythrocytes
) .

During bacteriological examination, the collected pathological material is placed in a special nutrient medium, which is designed for the cultivation and reproduction of pathogenic microorganisms. Observation of the development cycle of bacteria allows you to identify the type of pathogen against which, in the end, an effective antibacterial treatment will be selected.

Also, with perforation of the tympanic membrane, an ENT doctor may recommend computed tomography of the temporal bones for detailed visualization of the middle and inner ear.

Computed tomography is a modern and most informative diagnostic method, in which layer-by-layer x-ray scanning of any part of the human body is performed. This is a quick and painless procedure, during which the patient must lie down on a special moving couch and relax.

During the examination, the couch with the patient passes through the opening of the rotating ring, which scans the damaged part. After that, the computer processes the received information and displays its results on the monitor screen.

Prevention

In order to protect yourself from damage to the membrane and from all possible complications, it is imperative to adhere to preventive measures:

From all that has been said, we can conclude that it is possible to avoid such a disease only if all preventive measures are observed. With timely access to a doctor, the disease is treated very simply without complications.

Perforation of the tympanic membrane is, in other words, a rupture of the membrane separating the middle and middle ear It is well known that the middle ear is located between the outer (the one that we see) and the inner ear. This organ contains three small bones called the hammer, anvil, and stirrup.

It is these small bones that provide auditory function in the body. Due to colds and infections, inflammatory processes occur, which causes the formation of fluid, and often pus. Perforation of the eardrum occurs when this pus "finds a way" out. This is accompanied by a decrease (and in some cases loss) of hearing.

Also, the eardrum can perforate (rupture) due to injury. The cause of such an injury in many cases is the ingress of sharp objects into the ear (for example, when children play or when cleaning the ears with inappropriate products in adults) or sudden changes in pressure (explosions, blows to the head, jumping into water). Perforation of the tympanic membrane in children may be the result of a complication of infectious diseases.

Basic symptoms

This disease is very dangerous because it can lead to hearing loss (irreversible in some cases). When diagnosed with a perforated tympanic membrane, the symptoms will be as follows:

sharp, unexpected pain accompanied by bleeding;
dizziness;
ringing or buzzing in the ears;
hearing loss;
discharge from the ear (most often purulent).

If you find yourself with all or some of these signs, it is recommended to go to the doctor, and as soon as possible. The specialist will use an otoscopy (special examination) to give you a specific diagnosis.

In the event that the doctor has confirmed that you really have a perforation of the eardrum, the treatment will take place according to a certain scheme. If the discharge is injured, the discharge is collected and the doctor checks to see if it contains pus, or (which happens less often) If the doctor is unable to determine this on his own, the discharge is sent to the laboratory for analysis of its composition.

A sterile bandage is applied to the ear, of course, the outer one. If the eardrum is severely damaged, treatment may include immediate surgery. The purpose of this operation is to connect the film to eliminate significant damage to it.

This operation is called tympanoplasty, or myringoplasty. She is under general anesthesia. The surgeon makes a small incision above the ear, from which he takes a small piece of skin, with which he then sews up the damage in the ear membrane.

If the gap is small, you can do without surgical intervention, then the membrane will heal in a period of time from 8 to 10 days. At this time, you should be under the supervision of an ENT. But in some cases, even minor injuries do not heal naturally, and their treatment requires a mandatory operation.

Prevention

In order to speed up the treatment process and reduce the likelihood of complications, you should remember that until the membrane is completely healed, you should not blow your nose, pinching your nostrils, and you also need to make sure that no liquid gets into your ears (when bathing, cover them with cotton wool soaked in oil or cream).

urgent treatment of any ear infections, since the delay in the treatment of diseases of the middle ear often leads to the accumulation of fluid, which causes the aforementioned disease;
during flights on airplanes, it is recommended to either eat (suck) candy to protect the eardrums. This provides protection against sudden pressure drops. With a cold accompanied by a runny nose, it is better to refuse flights or, in extreme cases, use vasoconstrictor nasal drops before takeoff;
do not use sharp objects (hooks, hairpins, needles) to clean the ears;
avoid excessively long stay in noisy places.

The eardrum plays an important role in the correct and full functioning of the human hearing aid. Even a slight damage to this part of the ear can significantly reduce not only the quality of hearing, but also provoke the development of inflammation, leading to otitis media with possible complications.

Timely treatment for any type of damage to the membrane will allow you to safely endure the injury and maintain hearing health.

To prevent an increase in pressure on the eardrum and its rupture, it is necessary:

do not listen to loud music;
treat existing diseases (ARVI, influenza, sinusitis, rhinitis, tonsillitis);
do not overcool;
treat otitis media in a timely manner;
exclude small objects from entering the ear, since injuries can cause perforation;
exclude foreign objects from entering the ear cavity of children;
refuse to clean the ears with matches and other hard objects.

Prevention of eardrum perforation
– Timely treatment of inflammatory diseases of the middle ear. If you have signs of inflammation of the middle ear: constant dull pain, tinnitus and hearing loss, you should consult a doctor and do not self-medicate.

Delay in timely treatment can lead to the accumulation of fluid in the middle ear and perforation of the membrane.
– Ear protection when flying in an airplane. If you have a cold or an allergic reaction, it is advisable to refrain from flying.

In addition, during the flight it is recommended to wear protective headphones or chew gum or suck on candy.
– Try not to use sharp objects to clean the wax from the ears, as they can easily injure the eardrum.
– Avoid excessive noise.

timely treatment of inflammatory diseases of the upper respiratory tract;
Seek immediate medical attention if hearing loss occurs.
gentle toileting of the ears;
supervision of children;
timely prevention of eardrum rupture during airplane flights.

suck on lollipops;
insert cotton wool or earplugs into the external auditory canal;
massage the ears with the index finger;
open your mouth during takeoff and landing.

Gently and properly cleanse the body. It is especially important for parents to pay attention to hygiene procedures in children. In case of cleaning the organ with sharp objects, injury may occur.
Do not listen to loud music. It is important to avoid noise.
Timely and competently undergo a course of treatment for diseases of the nasopharynx and ear. The most likely cause of rupture of the septum is the untimely cure of inflammatory processes. With self-administration of drugs, otitis media may begin to progress and other consequences may develop.
Protect ear passages from liquid penetration. When taking a bath, it is recommended to use special caps that prevent liquid from entering. This reduces pressure on the inner ear.
Take action at the time of air travel. To regulate the pressure, use special earplugs.

Precautionary measures

To avoid perforation of the tympanic membrane, you must:

use special ear sticks for ear hygiene, and not various sharp objects;
protect yourself from the influence of loud sounds by means of protective headphones, and when flying by air transport, suck on candies during takeoff and landing;
prevent the occurrence of inflammatory processes in the middle ear and nose with the help of preventive measures, and if they occur, carry out timely treatment;
give up diving, flying on an airplane and listening to loud music with inflammatory ear processes.

Acute otitis media is often aggravated by the perforative stage, in which the integrity of the eardrum is violated. Such a complication must be treated strictly under the supervision of specialists in a medical institution in order to prevent the occurrence of negative consequences up to hearing loss.

Most ear diseases are treated topically with special drops, but not all drugs can be used if the patient has a ruptured eardrum.

What causes a perforation? What ear drops can be used to treat the pathology of the organ of hearing in case of a rupture of the eardrum?

Are you worried about something? Do you want to know more detailed information about Perforation of the tympanic membrane, its causes, symptoms, methods of treatment and prevention, the course of the disease and following a diet after it?

Or do you need an inspection? You can make an appointment with Dr.
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If you have previously performed any studies, be sure to take their results for a consultation with a doctor.

If the studies have not been completed, we will do everything necessary in our clinic or with our colleagues in other clinics.

You? You need to be very careful about your overall health. People pay insufficient attention to the symptoms of diseases
and do not realize that these diseases can be life-threatening.

There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called symptoms of the disease.
.

Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to undergo an examination with a doctor several times a year.
not only to prevent a terrible disease, but also to maintain a healthy spirit in the body and the body as a whole.

If you want to ask a doctor a question, use the online consultation section, perhaps you will find answers to your questions there and read self-care tips
. If you are interested in reviews about clinics and doctors, try to find the information you need in the section.

Signs of a ruptured membrane

If the injury is deep and hooked on the inner ear, then dizziness will appear. When a complete rupture of the membrane has occurred, then at the time of sneezing or blowing your nose, the air of their injured organ of hearing can be released.

The severity of symptoms depends on the extent of the damage. With minor injuries, the pain quickly disappears and hearing acuity worsens only slightly.

With severe damage, the inflammatory process can spread to the entire area of the inner ear.

Due to the violation of the integrity of the membrane, the penetration of infections provoke the occurrence of complications, such as:

labyrinthitis,
acoustic neuritis,
otitis.

With the penetration of microorganisms into deeper tissues, meningitis and encephalitis can develop. With an extensive rupture of the membrane, there may be hearing loss.

The selection of ear drops for the treatment of the ear against the background of a ruptured tympanic membrane should be made only by an otolaryngologist. The specialist will assess the condition of the cavity behind the perforated membrane, determine the true cause of your discomfort and select drugs that will cope with the existing inflammatory process without harming the functionality of the hearing organ.

The reasons for the rupture of the membrane separating the outer part of the ear from the tympanic cavity can be:

barotrauma;
acoustic trauma;
mechanical injury, for example, when cleaning the ears;
fracture of the temporal bone;
thermal damage at home and at work;
purulent otitis.

In this case, the gradual accumulation of exudate in the tympanic cavity leads to a strong and painful tension of the film. In the end, the eardrum does not withstand the pathogenic effects and pressure of purulent masses and breaks through.

A ruptured eardrum can be identified by specific signs.

If the membrane was perforated as a result of trauma (mechanical, baro- or acoustic), then patients experience severe pain at the moment of violation of its integrity. With a rupture of the eardrum against the background of accumulation of pus in the cavity of the middle ear, the symptoms will be slightly different.

After perforation, patients experience the following symptoms:

There may be tinnitus;
due to the loss of mobility of the eardrum, the quality of hearing decreases;
purulent masses come out of the auditory canal (with otitis media) or bloody and sanious discharge (with the traumatic nature of the membrane rupture).

The presence of perforation in the membrane not only negatively affects the quality of sound perception by patients, but the rupture of the membrane seems to open the entrance for infection to the middle ear. For the period of scarring of the connective tissue, you should take care to protect the organ of hearing from pathogenic bacteria and fungi - this is the purpose of the ear drops that the otolaryngologist will prescribe for you.

brain abscess

Cerebellar abscess

Adhesive otitis media

Angina Ludwig

Angina with measles

Angina with scarlet fever

Angina of the lingual tonsil

Anomalies in the development of the nose

Anomalies in the development of the paranasal sinuses

Atresia of the nasal cavity

Meniere's disease

Inflammatory diseases of the middle ear

Congenital preauricular fistula (parotid fistula)

Congenital malformations of the pharynx

Hematoma and abscess of the nasal septum

Hypervitaminosis K

Hypertrophy of the lymphoid tissue of the pharynx

angina

Diphtheria of the pharynx

Diphtheria of the nasal cavity

Zygomaticitis

Malignant tumors of the external ear

Malignant tumors of the middle ear

Ulceration of the nasal septum

Foreign bodies of the nose

Foreign bodies of the ear

Deviated septum

Cysts of the paranasal sinuses

labyrinthitis

Latent otitis media in children

mastoiditis

Myringitis

Mucocele

Otitis externa

Neurinoma of the vestibulocochlear nerve

Sensorineural hearing loss

Nose bleed

Burns and frostbite of the nose

Tumors of the nose and paranasal sinuses

Orbital complications of diseases of the nose and paranasal sinuses

Osteomyelitis of the upper jaw

Acute sinusitis

Acute suppurative otitis media

Acute primary tonsillitis

Acute rhinitis

Acute sinusitis

Acute otitis media in children

Acute serous otitis media

Acute sphenoiditis

Acute pharyngitis

Acute sinusitis

Acute ethmoiditis

Otoanthritis

Otogenic brain abscess

Otogenic meningitis

Otogenic sepsis

Otomycosis

Otosclerosis

Paresis of the facial nerve

Perichondritis of the outer ear

Petrozit

Influenza nasal cavity

Nasal lesion in whooping cough

Nasal lesions in measles

Nasal lesions in cerebrospinal meningitis

Basic symptoms

Prevention

If the eardrum is damaged, a rupture forms in it, as a result of which sound vibrations are disturbed, and a person may experience hearing problems. The danger of perforation is that it opens up access to infections in the middle ear, which causes otitis media. Therefore, it is important to detect the problem in time and start her treatment.

Causes of damage to the eardrum

acute otitis media;
chronic suppurative otitis media;
aerootitis;
direct damage;
noise injury;
acoustic trauma;
fracture of the base of the skull.

The reasons	Development mechanism	Description and symptoms
Acute otitis media	This disease occurs as a result of infection in the tympanic cavity. A typical development of acute otitis media occurs after a cold, as a result of which a person's immunity decreases. Due to the lack of immune protection in the nasal cavity, the number of pathogenic microorganisms increases, which leads to a rapidly developing inflammatory process. Due to inflammation in the middle ear, pus accumulates and pressure increases. All this leads to softening, thinning and perforation of the eardrum. Most often, infection enters the middle ear through the auditory tube ( tubogenic way ). Also, pathogenic microorganisms can enter the tympanic cavity with the blood stream ( by hematogenous route ) due to various infectious diseases ( e.g. typhus, tuberculosis, scarlet fever ). In most cases, acute otitis media can be caused by pathogens such as: hemophilic bacillus; bacteria of the genus Moraxella; mixed flora. Another reason for the development of acute otitis media can be various hypertrophic processes of the nasopharynx and nasal cavity, in which mechanical compression of the auditory tube occurs, which subsequently leads to violations of its drainage and ventilation function.	Inflammation of the middle ear. In the usual course, this disease has three periods. In the first period, an infectious process develops, in which a fluid characteristic of inflammation accumulates (exudate ). The first period is accompanied by the following symptoms: redness of the eardrum; protrusion of the eardrum due to the accumulation of exudate; hearing loss; dizziness; increase in body temperature (38 - 39 ° C ); general weakness; malaise. Lab results will show moderate signs of inflammation. The second period is characterized by perforation of the eardrum and prolonged suppuration from the ear ( about five to six weeks ). In the second period, the patient's primary symptoms change dramatically: subsides and completely disappears pain in the ear; body temperature normalizes; the general condition improves. In the third period, the inflammatory process subsides, the discharge from the ear stops, and the resulting perforation of the eardrum usually closes on its own.
Chronic suppurative otitis media	Most often occurs due to undertreated acute otitis media. There are two forms of chronic suppurative otitis media: mesotympanitis; epitympanitis. Mesotympanitis With this form, the auditory tube is involved in the inflammatory process, as well as the mucous membrane lining the tympanic cavity and the tympanic membrane. Due to inflammation of the auditory tube, its function is disrupted, which leads to frequent infection of the mucous layer and constant perforation of the tympanic membrane, usually in its middle or lower section. epitympanitis Most often, the inflammatory process is formed in the attic ( epitympanic space ). With this form of the disease, the mucous membrane and bone tissue of the tympanic cavity, as well as the mastoid process of the temporal bone, are affected. A characteristic feature of epitympanitis is the presence of persistent marginal perforation in the upper parts of the tympanic membrane.	It is characterized by persistent perforation of the eardrum. With mesotympanitis, the following symptoms usually occur: purulent mucous discharge from the ear ( can go on for years ); hearing loss; dizziness. With an exacerbation of the process, the patient also feels pain in the ear. Epitympanitis is accompanied by the following symptoms: pain in the temporo-parietal region; feeling of pressure in the ear; more pronounced hearing loss; dizziness. The complicated process of epitympanitis is characterized by putrid discharge from the ear with a fetid odor.
Aerootitis	Usually this phenomenon occurs in people during the flight on an airplane, usually at the time of takeoff or landing. In this case, a sharp difference appears between the pressure in the tympanic cavity and the pressure in the external environment. A concomitant factor in the occurrence of aerootitis is poor patency of the auditory tube. Violation of the patency of the auditory tube and a sharp drop in pressure leads to various pathological changes in the tympanic membrane ( retraction, hyperemia, hemorrhage, rupture ).	Pathological changes in the middle ear up to perforation of the eardrum as a result of a sharp drop in atmospheric pressure. There are the following symptoms of aerootitis: feeling of fullness in the ear; pain in the ears of varying intensity; noise and ringing in the ears; hearing loss; dizziness. The rupture of the eardrum will be accompanied by serous-bloody discharge from the affected ear.
Mechanical damage	Often occur when cleaning the ears with various objects ( e.g. with a hairpin, match ). In this case, the rupture of the eardrum occurs due to the accidental pushing of a foreign object inward. Another cause of a ruptured eardrum is an inept attempt to remove a foreign body from the ear.	A ruptured tympanic membrane is usually accompanied by pain and serosanguineous discharge from the ear.
acoustic trauma	Occurs due to sudden loud noise ( e.g. explosion ), at which the atmospheric pressure increases sharply. Strong condensation of air can cause perforation of the eardrum.	The effect of high sound pressure on the hearing organs. Accompanied by the following symptoms: sharp pain in the ears; noise or ringing in the ears; hearing loss. In severe acoustic trauma, contusion is likely, which can manifest as loss of consciousness, temporary or permanent hearing loss, dizziness, nausea and vomiting, and amnesia.
Fracture of the base of the skull	Occurs, for example, when falling from a height or after a strong blow to the head, after which the fracture line can pass through the tympanic ring.	Usually, with this pathology, the patient's condition is severe or extremely severe. Probably bleeding and CSF leakage ( cerebrospinal fluid ) from a ruptured eardrum.

First aid

If the eardrum is damaged, there is a high probability of infection entering the affected ear. The patient in this case must be as careful as possible. It is contraindicated to wash the ear, independently remove existing blood clots from its cavity, as well as dry it or apply cold to it.

First aid is limited to the introduction of a dry sterile turunda or cotton ball into the external auditory canal, bandaging the ear and transporting the victim to the nearest medical facility. With severe pain, you can offer the patient one tablet of diclofenac (

) or paracetamol (

During the transportation of the patient, it is necessary to ensure that he does not shake on the road. Also, the victim should not tilt or throw back his head.

If a foreign body enters the ear, the patient should not try to remove it. Thus, it is possible to injure the organ even more, as well as introduce an infection there. In this case, the help of an ENT doctor is necessary.

Doctors use a special hook to remove a foreign body. The instrument is gently inserted into the affected ear and pushed between the wall of the ear canal and the foreign body inside until the hook is behind it. Then the hook is turned, a foreign object is caught and the contents are removed.

Treatment of damage to the tympanic membrane is performed in a hospital in the otolaryngology department. In case of emergency admission, if necessary, the patient is stopped bleeding using tamponade and a bandage.

In the event that the excreted exudate is mucopurulent in nature, the ENT doctor performs manipulations aimed at ensuring a free outflow of pus. In this case, a sterile gauze swab is placed in the ear canal, and after a while it is replaced.

After removing the pus, the ENT doctor uses a catheter to infuse such drugs into the ear as:

dioxidine solution (0.5 - 1%
- an antimicrobial drug with a broad spectrum anti-inflammatory effect;
antimicrobial drops tsipromed (0.3%
with a wide spectrum of antibacterial action;
otof antibacterial drops (2.6%
.

The above drugs stimulate tissue repair, and also contribute to faster cleansing of the wound surface.

Antibiotic therapy

In inflammatory diseases of the middle ear, as well as in order to prevent the development of an infectious process, the patient is prescribed antibacterial drugs (

) in the form of tablets and ear drops.

According to the nature of the impact on pathogenic microorganisms, antibacterial agents are divided into two groups:

bacteriostatic antibiotics
, when using which bacteria do not die, but lose their ability to reproduce;
bactericidal antibiotics
, the intake of which leads to the death of bacteria.

Name of the drug	Application
Amoxicillin	Adults and children over ten years of age the drug is administered orally at 0.5 - 1.0 g three times a day. Children aged five to ten years appoint 0.25 g three times a day. Children aged two to five years appoint 0.12 g three times a day. Children under two years of age appoint 20 mg per kilogram of body weight, divided into three doses.
Lincomycin	The drug should be taken orally 0.5 g three times a day one hour before meals or two hours after meals.
Spiramycin	Adults you need to take one tablet (3 million IU ) inside, two to three times a day. Children weighing over 20 kg prescribe 150 - 300 thousand IU ( international units ) per kilogram of body weight, divided into two to three doses.
Ciprofloxacin	It is necessary to take the drug one tablet at a time (0.25 - 0.5 g ) by mouth, twice a day.
Azithromycin	The drug must be taken orally, once a day one hour before meals or two hours after meals. Adults appoint 0.5 g on the first day of admission, then the dose is reduced to 0.25 g from the second to the fifth day. children prescribe an antibiotic based on body weight. If a child weighing more than ten kilograms, he is prescribed ten milligrams per kilogram of body weight on the first day of admission and five milligrams per kilogram of body weight on the next four days.
Fugentin	Adults it is necessary to instill two to five drops into the external auditory canal three times a day. children the antibiotic is instilled one to two drops three times a day.
Tsipromed	Ear drops (0.3% ) should be instilled five drops into the external auditory canal three times a day.
Norfloxacin	The antibiotic is instilled into the external auditory canal one to two drops four times a day. If necessary, on the first day of taking the drug, one or two drops are instilled every two hours.

Approximate cost of medicines

Often, for treatment, patients resort to folk remedies. This approach cannot fully replace classical medicine, and it can be resorted to only after consulting a specialist.

To speed up the healing of a perforation, you need to eat more foods containing vitamin C:

rosehip decoction,
hawthorn,
citrus.

As a source of energy, you can eat grapes of sweet varieties.

Turunda for the ear can be moistened with plantain juice, pine needles, tincture of nightshade leaves (2 tablespoons of leaves pour 0.5 cups of alcohol).

The hole in the membrane remains long after the symptoms have disappeared. Therefore, it is imperative to control the healing process in order to prevent hearing loss and the transition of the disease to the chronic stage.

Ear medicines are designed to:

relieve inflammation and accelerate the healing of the eardrum.

With perforation, drops are allowed, which include antibiotics and steroidal anti-inflammatory drugs.

Otipax - drops with lidocaine
. They are mainly used for pain relief. The steroid, which is part of them, gives a slight anti-inflammatory effect on the membrane. If there is otitis media, then the use of Otipax drops alone is not enough.

Otofa - an effective remedy for perforation of the eardrum
. Broad spectrum antibiotic. It is not an analgesic, it is contraindicated in pregnant and lactating mothers.

Sofradex
can only be prescribed after a medical examination. Through the opening of the membrane, neomycin, which is part of the product, entering the inner ear, can provoke a toxic effect on the cells.

Candibiotic - a complex drug
from several antibiotics. In addition, it has an antifungal effect. For some, it can cause allergies. Therefore, before use, it is necessary to conduct a sensitivity test.

Amoxicillin is a drug with a bactericidal
and antibacterial effect. Treatment with this antibiotic should continue for at least 7 days.

The range of prices for medicines may differ depending on the region of sale and on the specific pharmacy chain. Here is the average cost of the most common drugs:

Otipaks -177 rubles;
Otinum -156 rubles;
Otofa -190 rubles;
Candibiotic -245 rubles;
Sofradex - 205 rubles;
Normax -101 rubles.

As can be seen from the material, the damaged eardrum in most cases can heal itself and does not entail serious consequences. The main thing is to diagnose the problem in time and prevent the development of a secondary infection. In any case, a doctor should prescribe treatment and examine the patient.

We offer you to watch a video instruction on the restoration of the eardrum.

perforation (tear
) tympanic membrane
- This is a pathological condition in which a hole or rupture of the membrane is formed, due to inflammatory diseases or injuries.

The tympanic membrane is a thin, small membrane located on the border between the outer and middle parts of the ear.

The eardrum performs the following functions:

protective
- prevents the penetration of foreign particles and microorganisms;
auditory
- is directly involved in the transmission of sound vibrations.

A damaged tympanic membrane tends to heal spontaneously. According to statistics, this occurs in 55% of patients. Most often, self-healing is observed with slit-like ruptures.

With a small perforation on the eardrum, there is not even a trace of damage. A more significant lesion leads to scarring of the organ. The resulting scar in the patient can cause hearing loss.

Not all ear drops presented on pharmacy shelves are approved for use against the background of perforation of the eardrum. The composition of many of them is quite aggressive and can harm the fragile and delicate structure of the middle cavity and the inner part of the ear.

To choose the right ear drops for a perforated eardrum, you should contact your doctor. The doctor will prescribe you the appropriate drugs that will successfully cope with all the problems that exist in your hearing organ and at the same time do not harm the functionality of the damaged ear.

At the moment, pharmacists do not have a universal remedy for the treatment of ears due to a ruptured membrane. You may need to use several drugs, each of which will deal with a specific problem.

Your doctor may prescribe the following ear drops that are approved for use with a perforated membrane:

Otipax. These are anti-inflammatory steroid drops with lidocaine. They not only extinguish the activity of pathogenic flora and relieve swelling of the mucous membrane, but also have a good analgesic effect. But this drug does not have a mild effect, and is not always able to cope with severe inflammation. Also, its use will be useless in the fight against a bacterial infection.
Otofa. These ear drops are also approved for the treatment of the organ of hearing on the background of perforation. They are effective in combating severe inflammatory processes, but they do not have an analgesic effect.
Sofradex. It is these drops that will be effective for bacterial purulent otitis media, but their composition is quite aggressive. If the substance gets into the inner ear, it can cause hearing impairment, so otolaryngologists try to prescribe this drug with caution against the background of perforation.
Candibiotic. These are complex drops that combine antifungal and antibacterial effects.
Amoxicillin. The most popular ENT antibiotic is also produced in the form of ear drops. It has a wide spectrum of activity and copes with most of the bacteria that cause inflammation in the ears.

Treatment Methods

Most (more than 50%) perforation of the membrane heals on its own without complications a few weeks after the injury and does not require special treatment procedures. Breaks that cover less than 25% of the entire membrane area heal faster.

The patient must adhere to rest, limit any procedures in the ear canal.

If the perforation is small, the specialist uses a paper patch to close it. Before this, the doctor treats the edges of the hole with a growth-stimulating agent, and applies a patch. 3-4 such procedures are necessary.

If an accumulation of blood clots or dirt is revealed during otoscopy, the doctor removes them with a cotton swab and lubricates the walls of the passage with alcohol, after which he puts a dry cotton turunda into the ear.

For small gaps, cauterization agents (silver nitrate, chromic acid, etc.) are used to close the perforation. These drugs treat the edges of the injury.

To avoid spreading the infection in the middle ear, the doctor may prescribe antibiotic therapy. When diagnosing acute otitis, a full comprehensive course of treatment is carried out.

If the medical method does not work or the area of the rupture is too large, then it may be necessary to undergo surgical treatment (myringoplasty).

The patient is given general anesthesia.

The doctor makes a small incision above the ear, takes a piece of skin from there and uses it to sew a hole in the membrane.

The operation is performed using a flexible endoscope, which is inserted into the ear canal. A skin flap is sewn to the membrane using self-absorbable threads.

The stitches help hold the patch in place until the injury heals. The dissolution time is several weeks. A swab treated with an antibacterial agent is placed in the ear canal.

After surgery, the patient may experience pain and discomfort. It is desirable, at first, not to make sharp retractions with the nose in order to avoid pressure on the healing eardrum.

Otherwise, the flap may move, which will disrupt its engraftment.

With perforation of the eardrum, the treatment of a child and an adult is most often carried out at home after a preliminary medical consultation. With the development of complications, hospitalization is required. With this pathology help:

medicines;
physiotherapy;
surgical intervention.

Myringoplasty

The following operations can be carried out:

Myringoplasty. Closure of the defect (hole) with a tissue flap taken from the fascia of the temporal bone. The first time after the operation you need to wear a bandage.
Ossiculoplasty. Replacement of damaged fragments of the auditory ossicles of the middle ear with prostheses.
Drainage.

In the absence of complications, complete recovery is observed within a week.

Medicines

In the treatment of this pathology are used:

Local antibiotics and antimicrobial agents in the form of drops (Otofa, Dancil, Uniflox, Dioxidin, Candibiotic, Anauran, Norfloxacin, Normaks, Tsipromed, Sofradex).
Anti-inflammatory and analgesic drops (Otipax, Otirelax).
Healing agents (Solcoseryl).
Systemic oral antibiotics (protected penicillins, cephalosporins, fluoroquinolones, macrolides). Aminoglycosides are not prescribed due to the ototoxic effect.
Vasoconstrictor drugs (Tizin Xylo, Galazolin, Naphthyzin, Sanorin, Rinostop).
Mucolytics (Fluimucil, Acetylcysteine, Vicks Active Expectomed). They liquefy the viscous secretion and improve its excretion.
NSAIDs (non-steroidal anti-inflammatory drugs) (Otinum, Diclofenac Retard).

The doctor should explain to the patient how to properly instill, why cold medicines should not be used. Before instillation of medicines in the ear, they must be warmed up so as not to cause tissue cooling and relapse.

Folk remedies

At home, you can use:

extract (tincture) of propolis;
perforated peroxide (hydrogen peroxide);
rosehip decoction;
juice of plantain and pine needles;
tincture of nightshade leaves.

If dry perforation of the tympanic membrane is detected, then treatment with folk remedies alone is not enough. They are not able to replace surgery and antimicrobial agents.

Because a ruptured eardrum can lead to complications, it's important to get it back to normal as soon as possible. The restoration of the health and integrity of the tympanic membrane, in the absence of complications, occurs independently.

Within 2-3 weeks, it completely overgrows and restores its functions. To speed up this process, adjuvant treatment of tympanic membrane perforation is prescribed. But if healing does not occur for a long time, plastic may be needed.

Therapy consists of a set of activities. The first stage is medical treatment. Since the symptoms of injury are accompanied by discomfort and pain, analgesics and anti-inflammatory drugs may be used to relieve them.

Ordinary ear drops are recommended to be applied in the form of turundas. Antibacterial drops and antibiotics are used only under the supervision of a doctor, as the ear has internal damage. It is important to get rid of otitis media and prevent tissue inflammation.

The second stage is ear protection. It is important for a child to prevent the penetration of water when bathing, as the consequences can manifest themselves in the form of acute inflammation. Use a cotton plug, gently clean the ear canal from secretions.

From physiotherapy, pneumomassage, UHF, blue lamp, electrophoresis are used. Thanks to them, the scarring of the eardrum after perforation is reduced, and the drops penetrate better into the tissues.

You also need to know what you can’t do if a membrane has burst in your ear, namely: it is not recommended, especially with suppuration, to wet it and clean it with cotton swabs. The use of medicinal drops without the permission of a doctor is also prohibited.

Ear restoration is possible with the help of myringoplasty. This is an operation to reconstruct the eardrum. Such plastic allows to close even extensive perforation and eliminate the consequences of chronic tympanitis.

If an injury was caused to the auditory ossicles, an operation is performed in parallel to restore them. A skin flap is engrafted in place of the membrane. For healing, drops and ointments are used. Treatment takes place in a hospital.

If the causes of perforation lie in purulent otitis, shunting and sanitation of the cavity can be used to eliminate pus. Medications are injected into the ear, and only then the plastic membrane is made.

Try to protect the ear from damage and inflammation in order to prevent the destruction of its elements and hearing loss.

Features of use

Ear drops prescribed by an otolaryngologist should be used strictly according to the scheme that the attending physician will write for you. Especially these recommendations relate to the use of antibacterial drugs.

Instill funds into the ears should be strictly on time, observing the dosage and intervals indicated by the doctor;
if you experience discomfort or side effects, inform the attending otolaryngologist about this, if necessary, he will prescribe you a different drug;
do not stop treatment immediately after symptomatic relief - antibacterial agents should be added to the end in accordance with the recommendations of the otolaryngologist;
at the end of the course of treatment, even in the absence of complaints, be sure to see a specialist - he will evaluate the results of therapy and the speed of scarring of the eardrum.

The human eardrum performs protective and sound-perceiving functions. Perforation of the tympanic membrane is a condition in which there is a rupture of a thin membrane between the outer and middle sections of the organ.

Some ear drops with a damaged eardrum can cause severe pain and do not improve the condition at all. That is why self-medication is so dangerous. Moreover, perforation usually occurs when otitis media is already running or the eardrum is damaged as a result of careless actions (trauma). Therefore, it is necessary to choose medicines in this situation very carefully, and better - only on the recommendation of a doctor.

Cause and effect

Treatment of the ear largely depends on the causes that caused the perforation of the eardrum. When it is damaged, several problems arise simultaneously: hearing deteriorates sharply, gates for infection open, and liquid discharge appears.

Effective drops in the ear during perforation of the eardrum should act simultaneously in several directions: relieve inflammation, heal wounds and prevent the reproduction of pathogenic microorganisms.

The most common reasons for a break are:

Barotrauma or a sharp drop in atmospheric pressure, in which there is an instant rupture of the membrane and leakage of fluid from the inner ear.
Acoustic injury - the same thing happens due to exposure to a strong sound wave.
Mechanical injury - can occur even with careless cleaning of the ears with sharp objects, but more often the eardrum breaks through when the temporal bone is fractured.
Advanced otitis media, in which pus has accumulated in the ear, creating pressure on the eardrum, causing severe pain and leading to perforation.

Only a doctor can diagnose a ruptured eardrum after a thorough examination using an otoscope. He also prescribes treatment, which usually includes not only drops and oral anti-inflammatory drugs, but also physiotherapy.

Ear drops

Ear drops for perforation of the eardrum are the best way to quickly relieve pain, as they act directly on the focus of inflammation. The most effective drugs are:

It is very important that drops in case of perforation of the eardrum are used until it is completely restored. And only a doctor can determine this moment.

Unfortunately, many patients stop dripping the prescribed drug on their own as soon as the pain and unpleasant symptoms disappear. But if the eardrum has not completely healed, then there is a high risk that the disease will flare up with renewed vigor soon after the drug is discontinued, and possibly lead to such serious complications as sepsis and hearing loss.

Ear drops for perforation of the eardrum: list, names, composition, description, effect of the drug, instructions for use, doctor's prescription and dosage

Most ear pathologies are treated locally with special drops, but not all drugs can be used when the patient has a ruptured eardrum. There are certain limitations and they must be taken into account. So, with the help of which ear drops can a perforation of the eardrum be cured? What medical preparations do specialists most often prefer? This will be discussed further.

Types of drugs

Topical preparations are selected by a specialist on the basis of what provoked the rupture of the membrane. Ear drops are:

Antibacterial. Such drops in the ears during perforation are prescribed if bacterial infection has led to the development of purulent forms of otitis media. Also, this type of drugs is also used for prophylaxis, in order not to allow the painful flora that has entered through the perforation to develop inflammatory processes.
Painkiller drops. With the help of such funds, the painful symptoms that accompany injuries with inflammatory processes are eliminated.
Antifungal. Such drops fight the fungus, they are prescribed for mycosis and as part of preventive measures against the background of antibacterial treatment.
Anti-inflammatory drops. This type of drug is prescribed to eliminate extensive inflammation against the background of injuries and purulent processes.
Antiseptic preparations. Disinfectant drops, as a rule, are included in complex therapy if there is a need for sanitation of the tympanic region.

What drugs are allowed for perforation?

Not all ear drops for perforation of the eardrum are allowed for use. The composition of many of them is quite aggressive, can harm the fine structure of the inner ear and middle cavity.

In order to correctly determine which drops can be used for perforation of the eardrum, a person should first of all turn to the ENT. The doctor will definitely prescribe effective medications that will soon successfully cope with absolutely all existing problems in the organ of hearing, while not harming the functionality of the affected ear.

At the moment, there is no universal remedy for the treatment of ears against the background of a membrane rupture on the pharmaceutical market. Patients may have to use several drugs at once, each of which will deal with a particular problem. Next, a list of drugs that are used in the treatment of a problem such as perforation of the eardrums will be considered in detail.

List of drugs

The doctor may prescribe the following ear drops to the patient for perforation of the eardrum:

Medicine "Otipaks". These are steroidal anti-inflammatory drops containing lidocaine. They stop the activity of pathogenic flora, and, in addition, relieve swelling of the mucosa, having a very good analgesic effect. But this drug does not have a mild effect, and can not always cope with severe inflammation. Also, its use will be useless in the fight against bacterial infections.

Ear drops "Tsipromed" for perforation of the eardrum

On the market today, a medicine called "Tsipromed" is quite widespread. In the treatment of ear pathologies, as a rule, a 0.3% solution is used. The main component is ciprofloxacin. Three times daily, it is recommended to instill these drops into the ears if a perforation of the membrane occurs. Dosing is chosen individually, and usually it does not exceed five drops for each procedure performed.

The drug in question is preliminarily kept for some time at room temperature, after which the ears are instilled with a pipette, directing the substance to the wall of the ear canal.

Also presented means is used for soaking a cotton swab. Such a tampon should be placed in a sore ear. Change it to fresh up to four times a day. Such therapy relieves painful symptoms after forty-eight hours.

What drops can still be used for perforation of the eardrum?

Drops "Uniflox"

In order to relieve perforation pain, doctors often prescribe ear drops called Uniflox. This remedy is based on an antibiotic, which is known in medicine under the name ofloxacin. It has a fairly high efficiency. As a rule, their therapy lasts about nine days, taking into account the fact that the drug is instilled in a timely manner into the affected ear, ten drops every eight to twelve hours.

Doctors often prescribe drugs based on the fairly well-known antibiotic norfloxacin, and as an example, a drug called Normax should be given. The course of treatment with ear drops for perforation of the eardrum is selected individually, but daily the drug is instilled up to 6 times, 2-3 drops of the drug.

Each of these drugs has many contraindications, they must be taken into account. Only an experienced specialist can do this.

Considering the features of the use of ear drops for perforation of the eardrum, it is necessary to pay attention to what recommendations are given when using them.

The main features of the application in the treatment

Drops for perforation of the eardrum should be used according to the scheme painted by the attending specialist. In particular, these recommendations relate to the use of antibacterial drugs. It is necessary to bury medicines in the ears strictly on time, in compliance with the dosages and intervals indicated by the doctor. You should also follow the following recommendations:

In case of manifestation of unpleasant sensations or the occurrence of side effects, it is imperative to inform your attending otolaryngologist about this, if necessary, the doctor will prescribe a different, more suitable drug to the patient.
You should not stop treatment immediately after achieving relief of symptoms. The fact is that antibacterial agents must be dug to the end, according to the recommendations of the otolaryngologist.
At the end of the course of therapy, even in the absence of certain complaints, it is imperative to see a specialist who will evaluate the result of the treatment along with the speed of scarring of the eardrum.

Conclusion

Thus, if you follow the above recommendations of specialists, you can achieve effective and quick recovery of the damaged eardrum. The main thing that should always be borne in mind, regardless of the complexity of the disease, is that any treatment must be coordinated with a qualified specialist.

Ear drops for otitis with perforation of the eardrum

Many of us have experienced such a disease as otitis media. It is treated with various medications. If, for some reason, you could not contact an otolaryngologist in time to prescribe appropriate therapy, then a purulent form of otitis media, aggravated by perforation of the eardrum, may occur. Such a pathology requires an immediate visit to a doctor who will select the necessary drops in the ears during perforation, which may help to avoid surgery.

Causes of eardrum perforation

Damage to the eardrum occurs under the influence of various adverse factors of a traumatic or infectious nature:

Inflammatory process in the middle ear of a purulent nature. There is a violation of the outflow of secreted pus due to blockage of the Eustachian tube, and it accumulates in the cavity of the middle ear. This increases intra-ear pressure on the tympanic membrane, which leads to its thinning and subsequent rupture. The middle ear loses its protection from any environmental influences.
Adhesive otitis, accompanied by a pressure drop and scarring of the inner parts of the ear. In this case, perforation of the membrane is diagnosed.
Ear hygiene with sharp objects not intended for this, or in violation of safety rules, which often causes injury to the eardrum, and subsequently the penetration of various pathogens into the middle ear.
Incorrect removal of a foreign body from the ear. Often occurs in children after unprofessional medical care.
As a result of a sharp immersion to a depth, the difference between internal and external pressures increases too quickly, and the water that has collected in the eardrum begins to press hard, up to its rupture. Such barotrauma can also occur while in an aircraft during takeoff or landing, sneezing with a closed nose.
Noise injury is caused by an unexpected explosion, gunshot, or other similar sound. In this case, hearing loss or partial hearing loss is usually observed.
Thermal burns with various hot industrial liquids when performing certain professional activities. At home, perforation can result from the inadvertent pouring of high temperature water into the ear area.
Ear injury as a result of a strong blow.
Fractures in the temporal bone or base of the skull.

How is a perforation treated?

analgesics - the removal of pain after an injury;
broad-spectrum antibiotics - localization of the inflammatory process;
mucolytic agents - thinning of mucus;
vasoconstrictor drugs - removal of puffiness and reduction of pressure on the membrane.

During otoscopy, blood particles or dirt may be found in the ear cavity. Then the otolaryngologist removes them with a cotton swab and treats the cavity with an antiseptic for disinfection (alcohol). At the end of the procedure, a sterile cotton wool turunda is placed in the ear for a certain time. If a small wound is found, its edges are cauterized with agents such as chromic acid and silver nitrate.

Injuries associated with a large area of membrane damage, as well as ineffective drug treatment, without fail require surgical intervention. There are the following types of operations:

myringoplasty. The surgeon makes an incision above the ear and takes a small piece of the skin of the temporalis muscle, which replaces the gap in the membrane. All this is sewn together with threads and absorbable material is applied on both sides, helping to hold the skin flap until it is completely engrafted. It takes 2-3 weeks. The operation is performed under general anesthesia;
tympanoplasty. When diagnosing impaired mobility and integrity of the auditory ossicles, they are surgically removed or replaced. Such an operation allows you to restore the normal functioning of these bone formations in the middle ear. The second stage is ossiculoplasty, which is performed under local anesthesia and consists in prosthetics of the auditory ossicles.

In the postoperative period, the patient will experience pain for some time, but this is normal, which will gradually pass.

Overview of Effective Drops for Perforated Tympanic Membrane

Drug therapy with antibacterial drops is aimed at eliminating inflammation in the ear area.

It is used for otitis of various forms as a bactericidal agent. When used topically, side effects from the digestive, nervous and urinary systems are possible, as well as allergic reactions in the form of itching, rash and swelling. For these reasons, such drops are prohibited during pregnancy, breastfeeding, individual sensitivity to the components of the drug and children under 15 years of age. Daily appoint 6 p. inject 2-3 drops into the ear.

The composition of these drops includes the antibiotic Ofloxacin as an active substance and benzahexonium chloride, disubstituted and monosubstituted sodium phosphate, water, as auxiliary components.

It is used as an antimicrobial agent for otitis and surgical interventions of an otological nature. For children, the drug is prescribed from 3 years of age. Up to 12 years, the dosage is 5 drops 2 r. per day, and at an older age it increases to 10 drops every 12 hours. The course of treatment lasts 10 days for external otitis, and 2 weeks for a purulent form. In childhood, the drug is used no more than 1 week.

The basis of these ear drops is the antibiotic ciprofloxacin. The excipients are sodium hydroxide, sodium chloride, benzalkonium chloride, lactic acid, sodium edetate and water. It is also an antibacterial drug from the group of fluoroquinils. Contraindications to the appointment are identical to the above Normaks drops. With purulent otitis media aggravated by perforation, the dosage is 5 drops 3 r. in a day.

In what cases are drops prohibited

The main contraindications to the appointment of the above ear drops:

pregnancy;
lactation period;
individual sensitivity to the antibiotic that is part of the drug;
children's age up to 3 years (Uniflox) and up to 15 years (Normax and Tsipromed).

Important: treatment with these drops should be carried out with caution in people with a predisposition to allergic reactions.

How to put drops in the ears

For the treatment to be effective, the following rules of instillation must be observed:

Before applying the drops, you must carefully clean the ear from dust and dirt. To do this, take a special cotton swab and moisten it in hydrogen peroxide or warm water. Then they squeeze it so that excess water does not get into the ear canal, and they clean it by several scrolls of the stick around its axis.
The bottle is heated in a bowl of hot water or held in the hands for 15 minutes to make the drops warm.
The patient is laid with his head on the pillow, with the diseased ear up.
Bring the vial dropper or pipette to the ear so as not to touch the skin. During instillation, pull the ear up and press it against the skull.
After instillation, you need to press on the tragus so that the drops penetrate deeper.
In the supine position, you need to remain for 5 minutes, and close the ear with sterile cotton to create a thermal effect.

Precautionary measures

To avoid perforation of the tympanic membrane, you must:

use special ear sticks for ear hygiene, and not various sharp objects;
protect yourself from the influence of loud sounds by means of protective headphones, and when flying by air transport, suck on candies during takeoff and landing;
prevent the occurrence of inflammatory processes in the middle ear and nose with the help of preventive measures, and if they occur, carry out timely treatment;
give up diving, flying on an airplane and listening to loud music with inflammatory ear processes.

Cause and effect

The most common reasons for a break are:

Barotrauma or a sharp drop in atmospheric pressure, in which there is an instant rupture of the membrane and leakage of fluid from the inner ear.
Acoustic injury - the same thing happens due to exposure to a strong sound wave.
Mechanical injury - can occur even with careless cleaning of the ears with sharp objects, but more often the eardrum breaks through when the temporal bone is fractured.
Advanced otitis media, in which pus has accumulated in the ear, creating pressure on the eardrum, causing severe pain and leading to perforation.

Ear drops

Ear drops for perforation of the eardrum are the best way to quickly relieve pain, as they act directly on the focus of inflammation. The most effective drugs are:

It is very important that drops in case of perforation of the eardrum are used until it is completely restored. And only a doctor can determine this moment.

Most ear pathologies are treated locally with special drops, but not all drugs can be used when the patient has a problem. There are certain limitations and they must be taken into account. So, with the help of which ear drops can a perforation of the eardrum be cured? What medical preparations do specialists most often prefer? This will be discussed further.

Types of drugs

Topical preparations are selected by a specialist on the basis of what provoked the rupture of the membrane. Ear drops are:

What drugs are allowed for perforation?

Not all ear drops for perforation of the eardrum are allowed for use. The composition of many of them is quite aggressive, can harm the fine structure of the inner ear and middle cavity.

List of drugs

The doctor may prescribe the following ear drops to the patient for perforation of the eardrum:

Ear drops "Tsipromed" for perforation of the eardrum

The drug in question is preliminarily kept for some time at room temperature, after which the ears are instilled with a pipette, directing the substance to the wall of the ear canal.

What drops can still be used for perforation of the eardrum?

Drops "Uniflox"

"Normax"

Each of these drugs has many contraindications, they must be taken into account. Only an experienced specialist can do this.

Considering the features of the use of ear drops for perforation of the eardrum, it is necessary to pay attention to what recommendations are given when using them.

The main features of the application in the treatment

Conclusion

Hearing is one of the most important human senses. Our ear has a rather complex structure, which ensures its full functioning. However, in some cases, this system fails. This situation can occur if there is a perforation of the eardrum, let's try to figure out how the ear can be treated with such a nuisance, what are the known signs of this pathological condition, and also answer the question of which drops are best used for the treatment of perforation of the eardrum.

How is perforation of the tympanic membrane detected, what signs indicate it?

A ruptured tympanic membrane is quite painful. Such a nuisance is accompanied by a sharp and acute pain in the ear. At the same time, various discharges of a transparent or purulent type can stand out from the ear, they are usually explained by the development of otitis media.

In the event that the perforation was provoked by injuries, for example, a foreign body or a noise injury, a small amount of bloody discharge is observed.

Among other things, if the perforation was the result of otitis media, then the breakthrough of fluid through the eardrum leads to a sudden decrease in pain. Many patients with this diagnosis also complain of the appearance of tinnitus, as well as hearing loss.

How is perforation of the tympanic membrane corrected, what is the treatment for the ear?

In most cases, a perforated eardrum heals easily on its own, without complications, about a couple of weeks after the rupture. In this case, the patient must adhere to rest and limit all possible procedures in the area of the ear canal to the maximum.

Drug treatment

In the event that a specialist finds that the disease does not want to be cured by itself, it is necessary to conduct an otoscopy and select an adequate treatment. With small perforations, doctors usually use agents that stimulate regenerative processes and apply a special patch to the eardrum.

In the event that during the examination the doctor found accumulated blood clots or dirt, they are removed using ordinary cotton wool. Next, the walls of the ear canal are smeared with alcohol and a turunda, rolled from dry cotton wool, is placed in the ear.

To eliminate small gaps, various cauterizing agents can be used, for example, silver nitrate, chromic acid, etc. Such compounds are designed to treat the edges of an injury.

To prevent and eliminate the spread of infection inside the middle ear, the doctor may prescribe antibiotic drugs to the patient. When acute otitis media is detected, appropriate complex treatment is carried out.

Surgical treatment

If the doctor detects a large amount of rupture or perforation of the membrane, and the method of conservative therapy does not give the expected effect, surgical correction is required. The patient is given general anesthesia and the integrity of the membrane is restored. For this operation, the doctor uses a small piece of skin from the area above the ear and uses it to stitch the hole in the eardrum. After the sewn-in piece is inserted on both sides, special absorbable materials are inserted to help hold the flap until it is completely engrafted. Recovery time is approximately three to four weeks.

After surgery, the patient may feel pain and some discomfort for some time. In addition, he is strongly advised not to blow his nose and not to perform sharp retracting movements through the nose.

Drops for perforation of the eardrum

Drug treatment of perforated tympanic membrane may involve the use of a variety of drops. Typically, such therapy is selected if the patient has otitis media. Medicines of this type have antibiotics in their composition and help to quickly cope with the disease and speed up recovery.

The drug of choice often becomes the medicine Tsipromed 0.3%. This medication contains ciprofloxacin. It should be used three times a day, instilling five drops into the external auditory canal. Before use, the medicine should be heated to a comfortable temperature (approximately body temperature). Therapy should be continued for two days after the disappearance of unpleasant symptoms. Experts advise tilting your head back after instillation of the product for about two minutes. It would also be nice to place a cotton turunda inside the external auditory canal.

Also, with perforation of the eardrum, the drug Uniflox is often used, which incorporates an antibiotic such as ofloxacin. Usually such a remedy is advised to instill ten drops at intervals of twelve hours. The duration of treatment is on average ten days.

In addition, the doctor may advise the use of drops, which are based on the antibiotic norfloxacin. This medicine should be used two to three drops at a time four to six times a day. The duration of therapy is selected individually.

It should be borne in mind that most of the drugs described cannot be used during pregnancy and breastfeeding, as well as in pediatric practice. They can provoke allergic reactions, various side effects and have other contraindications.

If you suspect a perforation of the eardrum, you should seek medical help in a timely manner.

Ekaterina, www.site

P.S. The text uses some forms characteristic of oral speech.