Condition Of The Middle Eartympanic Membrane Perforation

a. Description. The cause of this condition is usually trauma but occasionally the problem is caused by acute otitis media.

b. Signs/Symptoms. Included are:

(1) Occasional pain.

(2) Hearing loss.

(3) Blowing sensation in the ear caused by air passing through the tympanic membrane.

(4) Occasional clear or purulent discharge may be present.

c. Treatment. Treatment should not include medications in the ear or any packing of the ear. Keep the ear dry and clean. An external dressing is recommended. Oral analgesia is not usually needed. The patient should be restricted from flying, swimming, or heavy contact with loud noises. Keep water out of the ear. Systemic antibiotics should be given only if infections occur. Evacuation is not urgent unless a flap is present. If there is only a small perforation, called a "pinhole," no treatment is necessary. Some complications of this condition are the failure to heal spontaneously, ear infection, and scarring.

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