Dripped ear with perforation of the membrane. What ear drops can be used for eardrum perforation? Drops for perforation of the eardrum

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, which helps 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 a 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.

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.

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.

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.

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:

1. 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.
2. The bottle is heated in a bowl of hot water or held in the hands for 15 minutes to make the drops warm.
3. The patient is laid with his head on the pillow, with the diseased ear up.
4. 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.
5. After instillation, you need to press on the tragus so that the drops penetrate deeper.
6. 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:

1. 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 drugs 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.
2. Painkillers. With such drops, the painful symptoms accompanying injuries and inflammatory processes are eliminated.
3. Antifungal. Drops that fight the fungus are prescribed for mycoses and as a preventive measure against the background of antibiotic therapy.
4. Anti-inflammatory. This type of drug is used to relieve extensive inflammation against the background of trauma and purulent processes.
5. 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 the 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.

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:

1. 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.
2. 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.
3. 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.
4. Nausea. It is observed when the sound-perceiving apparatus is damaged. Often associated with vomiting.
5. Mucopurulent discharge.
6. Increase in body temperature. It is observed when the marginal perforation of the membrane arose against the background of purulent otitis media.
7. Deafness (hearing loss). Most often it is unilateral.
8. Weakness.
9. 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.
  

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.

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 details
  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 conventionally 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 tear in the membrane that separates 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 their 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 minor 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.

1. 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.
2. Do not listen to loud music. It is important to avoid noise.
3. 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.
4. 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.
5. 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.

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.

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 needed.

Doctors use a special hook to remove a foreign body. The instrument is gently inserted into the affected ear and pushed between the ear canal wall 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.

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:

1. 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.
2. 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.
3. 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.
4. Candibiotic. These are complex drops that combine antifungal and antibacterial effects.
5. 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 detected 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 surgical treatment (myringoplasty) may be necessary.

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:

1. 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.
2. Ossiculoplasty. Replacement of damaged fragments of the auditory ossicles of the middle ear with prostheses.
3. Drainage.

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

Medicines

In the treatment of this pathology are used:

1. Local antibiotics and antimicrobial agents in the form of drops (Otofa, Dancil, Uniflox, Dioxidin, Candibiotic, Anauran, Norfloxacin, Normaks, Tsipromed, Sofradex).
2. Anti-inflammatory and analgesic drops (Otipax, Otirelax).
3. Healing agents (Solcoseryl).
4. Systemic oral antibiotics (protected penicillins, cephalosporins, fluoroquinolones, macrolides). Aminoglycosides are not prescribed due to the ototoxic effect.
5. Vasoconstrictor drugs (Tizin Xylo, Galazolin, Naphthyzin, Sanorin, Rinostop).
6. Mucolytics (Fluimucil, Acetylcysteine, Vicks Active Expectomed). They liquefy the viscous secretion and improve its excretion.
7. 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 the eardrum has burst in the 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 dripped 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.

The ears are an important human sense organ. Its slightest failure leads to many problems, ranging from difficulties in communicating with other people, ending with the development of chronic diseases. Such failures often occur when the eardrum is damaged.

The eardrum is located at the junction of the inner and outer ear, which is why it is often damaged mechanically. A rupture, which in medical language sounds like a perforation, can occur not only as a result of the development of a pathological process, but also with incorrect hearing organs, as well as with various injuries.

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

Tsipromed

The drug is widely distributed. In the treatment of ear diseases, a 0.3% solution is used. The main active ingredient is . Three times daily it is recommended to bury such drops in the ear when the membrane is perforated. The dosage is selected individually and usually does not exceed 5 drops for each treatment.

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 is already 48 hours relieves painful symptoms.

Uniflox

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

Normax

The doctor often prescribes drugs based on the antibiotic Norfloxacin, for example, a drug. 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.

The use of ear drops in case of rupture of the eardrum is indicated only for those who have no contraindications to this type of drug.

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

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.

Perforation of the tympanic membrane- this is a violation of its integrity that occurs in the inflammatory process, mechanical impact, pressure difference inside and outside the tympanic cavity.
A perforation is said to be when there is a tear or hole in the eardrum, resulting in hearing loss. In addition, an infection can enter the middle ear through a hole in the membrane, which is fraught with the development of otitis media.

Perforation of the tympanic membrane: what are the causes

1. Inflammation in the middle ear. With a disease of otitis media, discharge accumulates, which can also be purulent. Due to a violation of the outflow of this discharge through the Eustachian tube, the fluid accumulated in the cavity of the middle ear presses on the eardrum, which also undergoes purulent fusion. Due to all these processes, it becomes thinner and torn, pus appears from the ear, and the membrane ceases to function as a barrier between the external environment and the middle ear.

2. Acoustic trauma or barotrauma. The membrane may rupture due to the accumulation of fluid on the inside. Pressure from the outside can also lead to a rupture, for example, if the palm is applied too sharply to the ear.

3. Foreign bodies. The eardrum can be injured when cleaning the ear with a cotton swab or any sharp objects.

4. Noise injury. Unexpected loud noise. This results in hearing loss and tinnitus.

Risk factors include:

• Fluid accumulation in the middle ear
• Excessive scratching in the ear due to itching in the ears
• Cleaning the ear from sulfur with hard objects (toothpicks, sticks, etc.).

Symptoms of perforation of the tympanic membrane

Among the main manifestations of rupture or perforation of the tympanic membrane are the following:

• Acute ear pain
• Bloody discharge from trauma (foreign object, direct or noise trauma)
• Purulent or clear discharge due to otitis media
• Relief of pain when fluid breaks through the membrane
• Noise in ears
• Hearing impairment.

Sometimes complications occur, such as:

• Hearing loss (usually temporary), with severe head trauma there may be severe or permanent hearing loss.
• Chronic otitis media, rupture of the membrane may be accompanied by infection in the middle ear cavity, resulting in the development of chronic inflammation.

Treatment of otitis media with perforation of the tympanic membrane

Perforation of the tympanic membrane occurs, as a rule, with chronic inflammation of the middle ear. A sign of perforation in otitis media is the appearance of various discharges from the ear (serous, purulent or bloody).
Perforation of the tympanic membrane does not pose a serious threat to human health, heals on its own. If it does not heal, then it must be treated in one of the following ways.

• Eardrum patch. A small gap is closed with a special paper patch. The edges of the gap are treated with a preparation for growth, then a paper patch is applied. About four such procedures are needed.
• Surgical intervention is necessary if the above method is ineffective and the rupture or perforation of the membrane is large. The operation, during which the surgeon stitches a hole in the eardrum, requires general anesthesia.

With uncomplicated damage to the membrane, treatment is minimized. It is forbidden to carry out any active actions on the tympanic membrane and in the external auditory canal, to let drops into the ear in case of perforation of the tympanic membrane and to wash the ear. If there are blood clots in the ear, they are removed with dry sterile cotton. The walls of the ear canal are treated with a cotton pad moistened with ethyl alcohol and squeezed out, and then dry sterile turundas are placed in it.

When complications such as purulent inflammation of the middle ear appear, treatment is prescribed that corresponds to acute purulent otitis media. If there are damage to the structures of the tympanic cavity, the necessary treatment is carried out until they are eliminated.

The eardrum is a thin, funnel-shaped skin that separates the ear canal. Perforation of the tympanic membrane means the formation of any hole or rupture in this place. This education is essential for the implementation of auditory functions. Without the tympanic membrane, the functioning of the hearing organs is impaired, because it participates in the transmission of sound, transmits air vibrations to the hammer. After this, the vibrations are transmitted to the auditory ossicles and to the inner ear. Perforation of the membrane leads to a violation of the perception of sounds, they may not be perceived clearly enough or not perceived at all.

It is important to remember that in addition to being responsible for the quality of sound perception, another function is assigned to the eardrum - protecting the middle and inner ear from infections. When a hole is formed, pathogenic microorganisms can freely enter the middle ear cavity, and this leads to an inflammatory process.

Causes of perforation

Perforation is the formation of a small hole in the eardrum. Violation of the integrity of the overlap can occur spontaneously, but at the same time it can be a necessary measure for treatment. A forced operation is performed if it is necessary to clean the ear cavity from accumulated purulent exudate. Such a membrane delimits the middle and outer ear, therefore, violations of its integrity affect the quality of hearing.

A rupture of the membrane can be triggered by several reasons, as a rule, this occurs as a result of trauma or an inflammatory process.

1. With adhesive otitis, a pressure drop often occurs, against the background of which the inner surfaces of the ear are covered with scars. Although adhesive otitis is a dry lesion, perforation is often diagnosed.
2. With purulent otitis media, an accumulation of purulent contents occurs, pressing on the membrane, against which thinning is formed. Damage to the eardrum with this type of otitis media is easy to notice, since there are signs of suppuration. Chronization of the process is extremely dangerous, because against such an unfavorable background, persistent perforation is manifested, tympanic membrane necrosis is often diagnosed.
3. Traumatic perforation of the tympanic membrane is the result of a negative mechanical impact. This often occurs due to violation of the rules for cleaning the ear canal. Perforation in children may be the result of the introduction of a foreign body into the ear canal.
4. Injury can be obtained as a result of pressure surges, blast waves, while flying in an airplane, while diving. When the pressure rises, retraction occurs, which causes perforation. Such an injury can be obtained as a result of cotton on the auricle.
5. Post-traumatic perforation of the tympanic membrane can occur due to head injuries, fractures of the bones of the skull, jaw.
6. Damage can occur if the acoustic impact is too strong. Sharp and strong vibrations lead to tension and injury to the auditory ossicles.

Treatment of perforation takes a long time. If damage of this kind is suspected, a specialist should be contacted immediately. Only timely assistance will be the key to a full recovery with an absolute restoration of auditory functions.

Possible complications

It is quite simple to limit the influence of negative influencing factors. For inflammation, drops are used that kill pathogenic microorganisms and reduce pressure on the eardrum.

The consequences of tearing the membrane are due to the nature of the injury and related factors. It all depends on the measures taken. Among the possible scenarios for the development of events are:

1. Healing. This is a completely natural process, the damaged membranes grow together on their own after a while (about 2 weeks), there is no trace of the rupture. Small scars form on the surface, which in most cases do not affect the quality of sound perception. It is important to note the need to use disinfectant solutions during this period. Only an otolaryngologist can choose the most effective drug. Therefore, self-medication is not worth it.
2. Necrosis occurs with prolonged infection, extensive perforation occurs. There is a high risk of suppuration and membrane death. The process can affect bone formations.
3. It is not excluded the development of miringitis as a result of infection from the outside.
4. , as a rule, develops in the absence of proper treatment, if the inflammation extends to the cavity of the inner ear.
5. Damage to the facial nerve. Nerve endings pass through the ear, including the exit to the facial nerve.
6. Perhaps the development of mastoiditis.
7. Cyst formation from epithelial outgrowths at the edges of the tear.
8. The development of conductive hearing loss.
9. A dangerous consequence is intracranial complications such as meningitis.

Characteristic symptoms

The symptoms of a perforated eardrum cannot be ignored. First, there is severe pain. Within 2-3 days after the injury, the pain will be quite severe, after about 5-7 days it will pass. It is important to note that in the presence of a purulent inflammatory process of the middle ear, the patient feels pain, but after the rupture of the membrane, on the contrary, it subsides.

Some of the symptoms of perforation include:

• feeling of sharp pain inside the ear;
• discharge of pus from the ear opening;
• the presence of bloody discharge (possibly with acoustic trauma);
• hearing loss.

It is worth remembering that if the cause of perforation is an infectious process, there is the possibility of complete hearing loss.

Hearing should be fully restored after the hole has closed. It is important to note that it is very difficult to define clear terms for overgrowth, it all depends on the size of the hole and aggravating factors. If the perforation occurred due to a complex head injury, the patient may completely lose his hearing forever. Inflammatory processes in the ear area must be treated very carefully and timely treatment should be started, delay in this case often causes the development and absolute hearing loss.

Diagnostic measures

Diagnostic activities include:

1. Otoscopic examination. Perforation of the tympanic membrane and can be detected by an otolaryngologist during the examination.
2. Otomicroscopy allows you to determine the severity of perforation and determine previously unrevealed nuances of the pathology.
3. Audiometry allows you to determine the sensitivity of the hearing organs to sounds.
4. Tympanometry allows you to directly determine the sensitivity of the eardrum.
5. A number of computer tests are carried out - impedancemetry.

Computed tomography and magnetic resonance imaging are often used when trauma is the cause of perforation of the eardrum. After identifying the cause of perforation, a special course of therapy is selected. For treatment, conservative methods are more often used: physiotherapy and medications, operations on the hearing organs are carried out in extreme cases. The responsibility for the outcome of treatment lies entirely with the patient himself, it is extremely important to protect the injured ear from external factors until complete recovery.

Treatment Methods

Perforation of the tympanic membrane does not require special treatment in most cases. If the hole occupies no more than 25% of the total membrane area, complications do not arise. The patient must follow the doctor's recommendations regarding the protection of the cavity, it is important to limit the conduct of hygiene procedures for the period of treatment.

If the perforation is small, the doctor uses a paper patch, before applying which he treats the edges with a solution that stimulates cell growth. Manipulation is repeated 3-4 times.

An otoscopic examination may reveal particles of dirt or blood in the cavity, then the doctor removes them with a cotton swab and treats the cavity with a disinfectant. Broad-spectrum antibiotics are often used to prevent the spread of infection. If the cause of perforation is otitis complex, a full course of treatment is carried out.

If the area of ​​the lesion is sufficiently extensive and drug therapy does not work, resort to surgical intervention. Myringoplasty is performed under general anesthesia. A small incision is made above the ear to take a piece of skin needed to sew the membranes together. The operation is performed using an endoscope, which is inserted into the ear canal. The edges of the tissues are sutured with self-absorbable sutures. The sutures securely hold the patch, which ensures a speedy healing.

Trying to heal perforation with folk remedies is not worth it. They are not able to replace a full-fledged treatment, and in some cases can cause a deterioration in the patient's well-being. It is also not recommended to use medicines and treat the ear cavity with disinfectant solutions without a doctor's prescription.

Prevention of perforation of the tympanic membrane

It is possible to prevent perforation of the eardrum.

• Hearing protection against exposure to loud noise should be provided.
• It is necessary to carefully clean the ears from the accumulation of sulfur, since the cause of perforation of the eardrum is often mechanical damage.
• You should not self-medicate otitis media - this pathology is one of the most common causes of perforation.

Much depends on the attitude of the patient to his own health. The manifestation of constant tinnitus and pain in the cavity is a reason to visit an otolaryngologist. If untimely, a rapid accumulation of pathogenic contents occurs.

In otorhinolaryngological practice, doctors often encounter such a pathology as perforation of the tympanic membrane. The most common causes of this disease are mechanical damage and otitis media. This pathology is manifested by pain, noise in the ear, hearing loss, discharge, dizziness and nausea. This condition is treated with medication or surgery.

rupture danger

Not all people without a medical education know what a perforation of the eardrum is. The human ear is very complex. Allocate external, average and internal departments. The membrane is located at the end of the external auditory canal. It is a thin membrane that separates the cavities. The membrane performs protective and auditory functions.

This formation consists of 3 layers. Perforation is a pathological condition in which the integrity of the eardrum is violated. This is manifested by the formation of a small hole or its complete rupture. Almost every second sick person heals independently. This is observed in the presence of a slot-like hole. This problem is faced by both adults and children.

Main etiological factors

When perforation of the eardrum, the causes can be very different. The following factors are of greatest importance in the development of this pathology of the organ of hearing:

• acute and chronic otitis;
• aerootitis;
• mechanical injury;
• acoustic trauma;
• skull fracture;
• the presence of foreign objects;
• infectious diseases.
• sudden pressure drops;
• barotrauma;
• thermal burn;
• exposure to caustic chemicals;
• shrapnel and gunshot wounds.

The most common cause of a perforated tympanic membrane is acute otitis media. This disease is infectious. The causative agents are cocci, Haemophilus influenzae, Moraxella and other microbes. They enter the middle ear through a tube or blood from other organs. Risk factors include: sinusitis, ozena, rhinitis, adenoiditis, tonsillitis, tumors. In children, the causes of otitis media and perforation of the membrane are influenza, diphtheria, scarlet fever.

In adults, possible causes include syphilis and tuberculosis. A common predisposing factor is a decrease in the body's resistance. In response to this, pathogenic and saprophytic microorganisms are activated. Often this pathology develops in people suffering from allergic reactions.

The mechanism of perforation of the membrane in acute purulent otitis media is the formation of pus against the background of the inflammatory process and increased pressure. The auditory membrane softens, becomes thinner and damaged. An important role in the perforation of the tympanic membrane is given to chronic otitis media. It can proceed according to the type of mesotympanitis and epitympanitis. In the first case, the mucous membrane in the region of the membrane and the auditory tube are affected.

Most often, perforation is observed in the lower or middle section of the membrane. With epitympanitis, not only the mucous membrane, but also the bone tissue, which is localized in the tympanic cavity, becomes inflamed. With this pathology, damage occurs in the upper part of the membrane. The state of the auditory membrane largely depends on atmospheric pressure. Often a condition such as aerootitis develops.

This pathology is often observed during an airplane flight. The basis is an increase in the difference between internal and external pressure. Damage to the eardrum is often observed due to the negligence of the person himself. This happens when cleaning the ears with sharp objects, picking with fingers. Possible causes include a skull base fracture.

Characteristic manifestations

With perforation of the tympanic membrane, the symptoms are few. They are determined by the main cause of membrane damage. At the moment of perforation, intense pain appears. Gradually she subsides. Then other symptoms appear. The symptoms of a perforation are:

• noise in the ear;
• a feeling of congestion;
• nausea;
• hearing loss;
• bloody or purulent discharge;
• dizziness.

Signs of intoxication appear if the perforation is due to acute otitis media. In this case, the body temperature rises. Often there are symptoms such as weakness, general malaise, chills. Nausea and dizziness are signs of involvement in the process of the vestibular apparatus. This is possible against the background of otitis media or traumatic brain injury. Nausea often appears on the background of acoustic trauma.

Sometimes it is combined with vomiting. Bloody discharge from the ear is a sign of damage to the blood vessels. This occurs with mechanical trauma. Purulent discharge indicates the presence of an inflammatory process. A common symptom of perforation of the membrane is the appearance of tinnitus. Sometimes patients feel the removal of air from the ear to the outside. This can happen while sneezing or blowing your nose.

The larger the area and depth of damage to the membrane, the more pronounced the symptoms. Small slit-like holes are not accompanied by severe hearing loss. The tympanic membrane borders on the auditory ossicles (stapes, malleus and incus). When they break, conductive hearing loss develops. If several symptoms appear, it is urgent to contact an otolaryngologist and undergo an examination (otoscopy).

Diagnostic methods

If the patient complains of pain, dizziness or noise, the ear must be examined. The following tests are required to make a diagnosis and establish the underlying cause of the perforation:

• external examination;
• palpation;
• otoscopy;
• audiometry;
• tuning fork test;
• impedancemetry;
• laboratory tests;
• microotoscopy.

Violation of the integrity of the auditory membrane is detected during otoscopy. This is an endoscopic method of research. To do this, you will need tools such as a forehead reflector, a funnel and an otoscope. In the process of otoscopy, the doctor evaluates the condition of the external auditory canal and membrane, and also determines the type of perforation. Perforation is rim and marginal. The size of the hole, shapes and localization are evaluated. Otoscopy can be performed several times.

Instrumental research is supplemented by laboratory diagnostics. It is necessary to exclude infectious pathology and determine the type of pathogen in the event of otitis media. The released secret is subjected to bacteriological examination. An increase in the level of leukocytes in the blood and an acceleration of ESR indicate the presence of an inflammatory process in the ear. In the event of a skull fracture, computed tomography or X-ray examination is performed.

Medical tactics

Treatment for damage to the eardrum is predominantly medical. You cannot do the following:

• independently clean the ear from pus and blood clots;
• wash the ear canal;
• dry;
• apply cold.

First aid to the patient includes the introduction of a sterile turunda, dressing and transportation to a medical institution. With severe pain syndrome, a drug from the NSAID group is used. If the cause of the perforation was the penetration of a foreign object into the ear, then you do not need to remove it yourself. This should be done by an otorhinolaryngologist. A hook is used to retrieve an item. It is important to provide the patient with complete physical rest. It is necessary to exclude the influence of noise.

In order to prevent infection, the ear canal can be treated with alcohol. For prophylactic purposes, systemic antibacterial drugs are prescribed. The most commonly used are fluoroquinolones and protected penicillins. In the absence of complications, ear drops can not be used. In severe cases, complex treatment is carried out. It is similar to therapy for otitis media.

With perforation against the background of purulent inflammation of the ear, the following groups of drugs are used:

• antihistamines (Zirtek, Zodak, Claritin);
• antibiotics;
• vasoconstrictor drugs in the form of nasal drops (Nafthyzin, Sanorin, Tizin).

In severe cases, corticosteroids may be prescribed. Anesthetic drops Otipaks, Otinum and their analogues are contraindicated in case of damage to the auditory membrane. If necessary, drugs are administered transtympanically. The toilet of the outer ear is obligatory. Erespal is often used to eliminate edema. When separating a thick, purulent secret, mucolytics (ACC) can be used.

Physiotherapy is indicated in the recovery phase. Ultraviolet irradiation or UHF therapy is carried out. In the stage of repair (healing) in acute otitis media, treatment involves blowing the auditory tube, pneumomassage, ultraphonophoresis and the use of proteolytic enzymes. Biostimulants are often prescribed. If the formed hole does not heal, then they resort to surgical intervention. The operation is performed with the ineffectiveness of conservative therapy, damage to the auditory ossicles, persistent hearing loss and traumatic brain injury.

The most commonly performed operations are tympanoplasty and myringoplasty. The defect is closed surgically. If more than half of the membrane area is affected, transplantation of human allofibroblasts is performed. Myringoplasty involves suturing a flap of the fascia of the temporal bone to the site of damage to the membrane. A bandage is applied. It is removed after a week.

Damage to the tympanic membrane in all cases leads to hearing loss and the possible occurrence of infectious inflammation in the middle ear. This gives a person not only discomfort, but also causes a lot of pain.

The eardrum is one of the most fragile parts of the human hearing aid. Therefore, its injury and rupture occurs quite often in both children and adults.

Timely detection of damage and prompt complex treatment will allow you to restore hearing functions without consequences and return to a normal full life. In many cases, rupture of the membrane is also possible with factors that in no way depend on the person.

Etiology of the disease ICD 10

A ruptured tympanic membrane is an injury to the thin skin that separates the ear canal from the middle ear. In the International Classification of Diseases 10 edition, traumatic rupture of the eardrum has the code S09.2.

A rupture of the membrane is said to be in the presence of damage, a hole and an obvious wound, that is, a rupture. In the presence of injuries of the membrane, a person suffers from unpleasant aching sensations, sharp pains, accompanied by tingling inside the ear.

When ruptured, the function of the eardrum is impaired. Thus, the normal vibrations of the membrane cease, and the vibrations of the air are distorted. This leads to the appearance of tinnitus, sometimes possible.

With a rupture, the symptoms in each individual case are individual. Depending on what caused the rupture, the manifestation of accompanying symptoms also depends. Treatment is also prescribed based on symptoms.

What does a perforated eardrum look like?

The reasons

A ruptured eardrum can occur for a variety of reasons. Among them, there may be consequences after blows or unsuccessful actions during the performance of physical work. The main types of reasons include:

1. Incorrect cleaning of the ears or getting into the ear canal. Improper hygiene measures can cause. After a piece of cotton wool or a piece of any other object remains inside the canal, infections begin to develop in the ear, which will later appear.
2. Loud and harsh noise. A sudden explosion, the noise of industrial equipment and machinery can also cause damage to the eardrum. Such damage is usually not so significant. For some time, hearing loses its sharpness, but as the membrane heals, it is restored. Sometimes the gap can be more significant, which is accompanied by the appearance of blood from the auricle and the appearance of pain.
3. Pressure. Sharp ones can easily lead to a violation of air pressure, which is more likely to lead to a rupture of the membrane. Precautions should be taken by those who are accustomed to sneezing with a closed nose and those who often fly on airplanes.
4. Inflammation. The inflammatory process that began inside the ear can lead to serious complications in the form of suppuration, severe pain. It is this pus that exerts pressure on the wall of the eardrum in the future, leading to its damage.
5. The impact of heat. Here we are talking about getting burns, which lead to a violation of pressure, which leads to a rupture. This type of gap is quite rare and is typical for people working in heavy industries.
6. Traumatic brain injury of the head. , falls and bruises, as a result of which a fracture occurs or serious damage to the temporal bone can also cause trauma to the tympanic septum.

Fans of self-cleaning the ears, who inadvertently clean the ear canals with cotton swabs, matches, pins, and even knitting needles, are at a significant risk of getting a rupture of the eardrum.

A rupture can also occur if you are potentially exposed to frequent accumulation of fluid in your middle ear.

Rupture of the eardrum with a cotton swab

Symptoms

When a membrane ruptures, a person may experience more than 10 symptoms, indicating that something has happened to his ears. The symptoms of each person are different and may at the very beginning manifest themselves more aggravated, and then go into decline.

In general, a person may experience the following symptoms:

• in the ear area;
• the appearance of a viscous liquid or bloody discharge from the ear canal;

Of the additional symptoms, a person manifests malaise, weakness, some disorientation. When taking an anamnesis by a doctor, patients complain of aching pain inside the ear, which directly indicates the presence of an inflammatory process.

Signs of a ruptured eardrum

1. Among the primary symptoms, there is a sharp pain in the ear. In some cases, the pain occurs so unexpectedly and sharply that people can even lose consciousness.
2. For some time, the pain remains strong enough, the person feels a pulsation.
3. There may be fluid due to rupture, but not necessarily. Allocations may appear much later.

After detecting such signs, it is better not to delay with an independent diagnosis and urgently go to the doctor for an examination.

How to determine in children?

A ruptured tympanic membrane manifests itself in children in the same way as in adults. The only problem is that the child may not orient himself in time and not understand what happened to him.

This can significantly delay the process of diagnosis and diagnosis. So, if you find that your child has become restless, constantly touching the ear, scratching or holding it, try to find out if pain inside the ear canal bothers him.

Even if the child categorically denies everything, do not be lazy and show your baby to a specialist to exclude the possibility of a gap and.

Diagnostic methods

In addition to collecting an anamnesis, the doctor performs an otoscopy without fail.

This simple and completely painless procedure allows you to detect the presence of a rupture or any other changes in the ear canal.

Inspection allows you to determine the degree of rupture. In the presence of pus or any other suspicious discharge, the doctor takes a small amount of fluid for analysis.

This allows you to identify a potential infectious agent and prescribe effective antibiotics when drawing up a treatment plan.

Treatment

With an ordinary rupture of the eardrum, the most sparing treatment is prescribed. In most cases, the damage heals on its own without outside help. Quite rarely, the doctor may have an aid that will speed up this process.

Sometimes lotions may be needed, they can relieve discomfort and reduce itching. During treatment, do not take sharp breaths and exhale through the nose. You should also control the desire to sneeze. Active movements are also prohibited until the membrane is completely restored.

How are tympanic membrane ruptures treated in clinics:

Medically

In the presence of an inflammatory process, a course of antibiotics and auxiliary drugs is prescribed. Such a need occurs only in the presence of thick pus and blood discharge, which is also accompanied by severe itching and discomfort inside.

In case of inflammation, the ear must be covered with a sterile patch, which is replaced about 3 or 4 times. In the process of changing patches, the ear must be treated with a special solution or ordinary alcohol.

Some patients are prescribed drops - anti-inflammatory substances, for example, otofa, and others.

Physiotherapy

Physiotherapy involves a number of simple recommendations. They include following a regime of calm and rest, which would allow a torn membrane to recover normally without complications.

During the treatment process, it is not recommended to resort to active physical exercises, taking hot and excessively cold baths. It is worth refraining from listening to music with headphones and going to places where there may be excessively loud sounds.

Folk remedies

Folk remedies have rather a general strengthening and complementary effect, which will be quite appropriate for general treatment.

To speed up the healing of the membrane, you should accustom yourself to consume more vitamin C. You can find it not only in fruits. For a faster normalization of the state, you can use:

• tea from rosehip broth;
• hawthorn tea;
• juice from sweet grapes.

You can also use plantain juice, an infusion of pine needles and nightshade to moisten a cotton swab and put it in a sore ear.

You can learn more about the functions of the eardrum in our video:

Effects

The complications caused by a rupture are directly related to how quickly the damage was discovered. The main danger lies in the ability of microorganisms to penetrate deep into the ear, which provokes the development of serious inflammation.

At the initial stage, a person is noted. Further, even deeper penetration of the infection is possible. This in turn causes a series of inflammations of the ear structures. They are accompanied by human weakness,.

With the deepest penetration of the infection, a person develops diseases such as. In the absence of qualified assistance, the patient may face death or lifelong disability.

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Classmates

Eardrum(lat.membrana tympani) - a thin membrane that is impermeable to air and liquid, separating the outer and middle ear. It serves to transmit sound vibrations to the inner ear, and also prevents foreign bodies from entering the tympanic cavity.

The eardrum is a thin funnel-shaped skin that separates the ear canal from the middle ear. The role of the tympanic membrane is to transmit air vibration - sound - to the hammer. Its vibrations are transmitted to this auditory ossicle, and further along the system of auditory ossicles - anvils and stirrup - to the inner ear.

Perforation of the tympanic membrane- this is when there is a hole or a gap in it.

In the event of a rupture of the eardrum or the presence of a hole in it, its vibrations can be disturbed, which, in turn, leads to hearing loss.

The presence of a hole in this membrane contributes to the infection in the middle ear cavity, which is fraught with its inflammation - otitis media.

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 PERFORATION OF THE TYMBRANE

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, it becomes 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.

Barotrauma, or acoustic trauma (Latin baro - pressure)

When fluid builds up on the inside of the eardrum, it can rupture.

Pressure from its outside can also lead to 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 a 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.

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.

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 TYPICAL PERFORATION

Accumulation of fluid in the middle ear.

Self-cleaning of the ear from sulfur with hard objects (sticks, cotton, etc.).

Excessive scratching of the ear due to itching in the ears.

MANIFESTATIONS OF PERFORATION OF THE EARDRUM

A ruptured eardrum, especially at the very beginning, can be quite painful.

Manifestations:

Sharp sharp pain in the ear.

Clear or purulent discharge from the ear when the membrane is perforated due to otitis media.

Bloody discharge from the ear with a traumatic 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.

DIAGNOSTICS

Otoscopy- 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.

Depending on the cause of the tear or perforation, there may be blood or pus in the ear canal. In the presence of pus, the doctor takes a small amount of it with a loop to analyze and identify the pathogen and determine the effectiveness of antibiotics.

COMPLICATIONS OF PERFORATION OF THE EARDRUM

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.

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.

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.

TREATMENT OF PERFORATION OF THE EARDRUM

In most cases, the perforation of the membrane heals on its own without complications within a few weeks.

In the event that the healing of the membrane does not occur, treatment is necessary.

Tympanic membrane patch

With a small tear or perforation, the doctor can close it with a so-called paper patch. Before this, the edges of the gap are treated with a drug to stimulate growth, after which a paper patch is applied to the gap.

Three to four such procedures may be required to completely close the gap.

Surgery

In the case of a larger rupture or perforation of the membrane and if the above method is ineffective, surgical intervention may be required.

The operation to restore the integrity of the eardrum is called tympanoplasty or myringoplasty.

The operation is performed under general anesthesia.

The surgeon makes a small skin incision above the ear. A thin piece of skin is taken from it. It is used to stitch a hole in the eardrum. The surgeon inserts a special microscope into the ear canal and then the whole operation is carried out with its help through the ear canal. The tympanic membrane is lifted, and the flap is placed against the opening in it. On both sides of the membrane, special absorbable materials are placed to help hold the flap in position until it is completely healed.

After a few weeks, this material is completely absorbed.

A tampon moistened with an antibiotic is placed in the ear canal for a period of three to four weeks, until the flap is completely engrafted to the eardrum.

In the first time after the operation, some pain and discomfort may be noted.

It is recommended not to blow your nose and not to make sharp retracting movements through the nose. This is due to the fact that on the back wall of the nasopharynx there are openings of the auditory (Eustachian) tubes that connect the nasopharyngeal cavity with the tympanic cavity. The role of these pipes is to equalize the pressure in it. With sudden movements of air in the nasopharynx, the pressure in the tympanic cavity may increase, which leads to the movement of the tympanic membrane, and this, in turn, is fraught with displacement of the flap and a violation of its engraftment.

Surgical closure of the perforation of the membrane leads to:

Preventing water from entering the middle ear while showering, bathing or swimming, and therefore preventing the development of infection in it.

Improve hearing.

Eliminate tinnitus.

Prevention of a special cyst in the ear - cholesteatoma, which leads to chronic infection in the middle ear.

PREVENTION OF PERFORATION OF THE TYMBRONIC MEMBRANE

Prevention of eardrum perforation:

Try not to use sharp objects to clean your ears from sulfur, as they can easily injure the eardrum.

Avoid excessive noise.

Timely treatment of inflammatory diseases of the middle ear. If you have signs of inflammation of the middle ear: persistent 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.

Some ear diseases can lead to a complication in the form of damage to the integrity of the eardrum. At the same time, self-selection of drugs can be extremely dangerous, since some drugs worsen the condition and lead to painful sensations. Damage can also occur as a result of trauma. Therefore, choosing ear drops for eardrum perforation is not an easy task.

Causes of damage

When examining a patient, the doctor first of all establishes the causes that led to ear damage. Most often it is:

• head injury;
• trauma when penetrating into the ear with sharp objects;
• injury after exposure to a very loud sound;
• injury after exposure to high atmospheric pressure;
• complications after otitis.

In the acute form of otitis media and untimely treatment, purulent discharge accumulates in the ear. They affect the eardrum and can lead to its rupture. This condition is accompanied by severe pain.

Damage symptoms

When the membrane is ruptured, the patient first of all feels severe pain. In some cases, there is bleeding from the ear. The patient feels tinnitus and short-term hearing loss.

If purulent discharge from the ear appears, this indicates an exacerbation of the inflammatory process, in particular, otitis media.

It is believed that minor injuries heal on their own if you do not listen to loud music and limit physical activity. However, experts strongly recommend seeking medical help, as a neglected disease can lead to serious complications.

Treatment

Damage is fraught with deterioration and complete loss of hearing. In addition, there may be severe pain and discharge from the ear.

If a ruptured eardrum is suspected, a specialist examines the inside of the ear using an otoscope. If damage is detected, the doctor prescribes special ear drops that reduce inflammation and have an antiseptic effect. Some drugs act directly on the rupture site and contribute to the rapid regeneration of damaged tissues. As an additional therapy, anti-inflammatory drugs and physiotherapy are prescribed.

At the beginning of treatment, the doctor places a piece of gauze soaked in a special anti-inflammatory solution into the ear canal. The medicine has a bactericidal effect and kills harmful bacteria.

In case of a serious injury, a surgical operation is prescribed, which ends with suturing the eardrum.

During the treatment of perforation, it is necessary to refrain from listening to loud music and to minimize the ingress of water into the ear canal. Doctors recommend covering the ear with a dry cotton swab to prevent dust and infection from entering the inflammation site.

Choice of ear drops

Medicines should be prescribed by a doctor, taking into account the patient's condition, his medical history and possible contraindications. Let's take a closer look at the most common ear drops.

Otipax

This drug belongs to the steroid group of drugs. It contains lidocaine, which has a strong analgesic effect. Otipax is rarely prescribed for perforation of the eardrum, although it quickly alleviates the patient's condition. This medicine is not used in the treatment of otitis media, as it does not contain antibacterial components, it is an anesthetic drug.

If necessary, it is prescribed even to pregnant women. At the same time, taking otipax can cause an allergic reaction, so people with intolerance to certain drugs should stop using these ear drops. But it is not recommended to use it for perforation.

Otofa

Otofa with perforation of the eardrum is able to cope with even the most severe form of inflammation. Active active ingredients effectively fight pathogens.

The disadvantage of Otofa is the absence of painkillers in the composition, therefore, additional drugs are usually prescribed to relieve pain.

Contraindication to the use of these ear drops is the age of up to 14 years, pregnancy and lactation.

Sofradex

In an acute inflammatory process, Sofradex can be used. The main active ingredient of the drug is a powerful antibiotic that kills pathogenic bacteria. As a result, inflammation is reduced.

A significant disadvantage of Sofradex is its toxic effect on the body. The dosage is carefully selected by a specialist after examining the patient. 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

This drug is recommended for use in acute otitis media. Candibiotic contains an effective antibacterial substance that fights inflammation. In addition to the antibiotic, Candibiotics contains an antifungal agent that kills harmful fungus in the ear cavity.

Contraindication to the use of the drug is pregnancy, lactation and age up to 12 years. In case of violation of the integrity of the eardrum, it should be used carefully and only after the recommendation of a doctor.

Amoxicillin

This drug is the cheapest among similar drugs, but is not inferior to them in terms of effectiveness.. Amoxicillin fights pathogens and reduces inflammation after the first application. This remedy promotes the rapid healing of damaged tissues and prevents the infection from moving deep into the ear. It is used in the form of tablets as an aid.

Among the contraindications, individual intolerance to the components of the composition and pregnancy stand out.

Amoxicillin has the best effect with long-term treatment lasting at least a week.

Tsipromed

This drug has antimicrobial and anti-inflammatory effects. It is recommended to instill a 0.3% solution of Tsipromed into the ear at intervals of 4-5 hours. The maximum dosage is 5 drops per instillation. Treatment continues until complete healing. With purulent otitis media aggravated by perforation, the dosage is 5 drops 3 r. in a day.

The main active ingredient of Tsipromed is ciprofloxacin. This component is most effective at room temperature.

A clean pipette is usually used to inject the drug into the ear cavity. Drops are sent to the wall of the ear, then roll down to the eardrum.

An alternative use of the drug is a piece of gauze or a cotton swab soaked in a medicinal solution. The tampon is kept in the ear cavity for about 5 hours.

Uniflox

This drug is prescribed to reduce pain. The main active ingredient of the drug is ofloxacin, which reduces inflammation. As a rule, the duration of treatment with Uniflox is 1.5 weeks. The drug must be dripped into the ear twice a day at the dosage prescribed by the attending physician.

Normax

Normax has an antimicrobial effect. Norfloxacin, contained in the drug, effectively fights inflammation that has arisen. The dosage of the drug is 2-3 drops every 2 hours. In any case, before use, you should consult with your doctor.

Important Notes

It is believed that the main symptom is pain. Therefore, some patients believe that treatment ends with the disappearance of pain. Actually it is not. Only a specialist can assess the condition of the ear and its constituent parts after using certain equipment.

It is very important to complete the treatment so that the disease does not spill over into an acute form.. It is necessary to completely eliminate the inflammation and wait for the complete healing of the damaged tissue.