Causes of a burst eardrum
External Causes of a Burst Eardrum (most
frequent cause)
An external cause for a burst eardrum is a
head trauma such as a blow to the ear or an
object penetrating the ear canal and penetrating the eardrum.
An immediate trip to the emergency room is
mandatory. The ER nurse or doctor will clean the
ear carefully give you an antibiotic shot and
antibiotic ear drops, then prescribe antibiotic
tablets for a 10 day regimen. In severe cases,
you may be referred to an ENT specialist (Ear,
nose, Throat specialist).
Usually, the larger the perforation, the greater the
loss of hearing. The location of the hole
(perforation) in the eardrum also effects the degree
of hearing loss. If severe trauma (e.g. skull
fracture) disrupts the bones in the middle ear which
transmit sound or causes injury to the inner ear
structures, the loss of hearing maybe quite severe.
With a traumatic or explosive event, the loss of
hearing can be great and ringing in the ear
(tinnitus) may be severe. In this case the hearing
usually returns partially, and the ringing diminishes
in a few days.
Side effects of a perforated eardrum (burst
eardrum) will definitely be excruciating pain.
You will probably also suffer from
vertigo and/or tinnitus
If a burst eardrum fails to heal (3-4 weeks) you may need a tympanoplasty to repair the eardrum.
The perforated eardrum can also be treated by an operation called a myringoplasty, where a tissue graft
is used to seal up the hole. (See below under Treatment)
Internal Causes
of a Burst Eardrum - Otitis Media
Perforated eardrums from internal causes are
usually from
middle ear infections (otitis Media) (viral or bacterial).
Detritus from the infection in the inner ear
causes pressure to build in the middle ear
cavity and if not relieved, the eardrum will
burst outward.
Symptoms of a burst eardrum from internal causes
- Sharp pain as the eardrum bursts, then initial pain relief.
-
Pus discharge from the ear, and usually very smelly
-
Bleeding from the ear
-
Hearing loss
-
Tinnitus
-
Vertigo
-
Throbbing pain as the middle and inner ear is subject to direct contact with the air
Outpatient treatments for a burst eardrum
OK. Your eardrum just burst . If you have had a
middle ear infection
that pushed out the eardrum, then the throbbing pain
has been greatly diminished. Wipe off the smelly
pus with a damp cloth, and sit quietly with a warm
compress on that side of the head.
If you can tolerate a
few days of
associated vertigo, dizziness, and dull pain from
the open ear drum, you may not need to see a doctor
as the hole will in all likelihood heal on its own. It will depend on
the size of the hole, and the extent of the inner
ear infection. If you still don't feel good after
three days, it probably means the middle ear
infection is still present and needs to be treated.
Antibiotics are usually prescribed, sometimes initially by injection, then a regimen orally three times a day for at least 7 days.
Note:
In the past, antibiotics such as penicillin, erythrocyn, or erythromycin were prescribed. However, in the last few decades, many in the general population have become immune to the effects of these antibiotics, and stronger ones are often prescribed.
(The cause of immunity is often blamed on
the same antibiotics fed to the food supply (chickens and beef)) before they are brought to market.
The most common antibiotics in use today are doxycycline™ and Cipro™
If a hole in the eardrum does not close
naturally within two weeks, it should attempted to be closed
by other methods ASAP to prevent the possibility of water entering the ear while
showering, bathing, or swimming (which could cause
or exacerbate an
ear infection).
As the eardrum heals, you will probably notice a
marked improvement in your hearing over the prior
days. During the healing process, any vertigo,
dizziness, tinnitus and pain should slowly abate.
A healthy healing eardrum may also prevent the development of
a cholesteatoma (skin cyst in the middle ear), which
can cause chronic infection and destruction of the
ossicles.
Small perforation - possible procedures:
- If the perforation is very small
and it does not heal after 2-3 weeks,
an ENT may decide not to operate and allow nature
to take its course and let the eardrum heal
naturally.
- For a larger
hole/tear, an outpatient
visit to the ENT will allow a small patch
(taken from under the skin behind the ear perhaps)
to be attached (not completely covering the hole)
over the hole to help it
shrink and encourage new skin growth.
- Another technique
an ENT may use to encourage healing is to add a chemical to the edges of
the hole to stimulate growth and
then place a thin paper patch on the eardrum to
act as a base for skin growth over the hole.
Several applications of
the patch (up to three or four over 3-6 weeks) may be required before
the perforation closes completely. if your physician
feels that a paper patch will not provide prompt or
adequate closure of the hole in the eardrum, or
attempts with paper patching do not promote healing,
surgery under general anesthesia is usually
recommended.
- There are a variety of surgical techniques, but all
basically place tissue across the perforation
allowing healing. The name of this procedure is
called tympanoplasty or myringoplasty. Surgery is
typically quite successful in closing the
perforation permanently, and improving hearing. It
may be done as a day-surgery basis.
Tympanoplasty Surgical procedure
Under general anesthesia in
a hospital setting, a surgical cut made behind
the ear, through the mastoid area. Then the ear
is moved forward to expose the eardrum. The ear
drum is also lifted up to expose the middle ear
or the inside of the ear. The eardrum is cleaned
and the infected area (if any) is cut away.
Next, a piece of fascia ( tissue from under the
skin), known as graft is taken from behind the
ear. The graft is inserted into the inside of
the eardrum where the edges of the hole are
folded back onto the perforation to close the
hole. Surgical glue may be applied to keep the
tissue in place.
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