Tympanic Membrane Perforation

What is Tympanic Membrane Perforation?

Ear drum is a membranous oval shaped structure which separates external ear from the middle ear. It is a vital part of healthy hearing, and it vibrates when struck by the sound waves. These sound vibrations are then conducted via three ear bones (ear ossicles) to the cochlea (inner ear). From inner ear sound is travelled via hearing nerve to the brain.

Causes of Ear Drum Perforation:

• Repeated middle ear infection (otitis media) or following acute otitis media (AOM)
• Traumatic injury by small objects or Q-tips
• Exposure to loud sounds
• Barotrauma
• Head injury
• Persistent ear drum perforation after grommet insertion

Symptoms of ear drum perforation:

• Hearing difficulty (Conductive hearing loss)
• Ear discharge in case of ear infection
• Ear discomfort/ ear blockage sensation
• Tinnitus
• Dizziness/ vertigo
• Ear pain

Treatment of Ear drum perforation:

• Most acute perforations following AOM will heal spontaneously after proper treatment with antibiotics.
• Small traumatic perforations will also heal spontaneously but patient needs to maintain strict water restrictions and should follow up with an ENT doctor until perforation is healed. It usually takes 3-4 weeks for these perforations to heal.
• In case of ear drum perforation which has not healed after few months and patient is getting repeated ear infections and drainage, then procedure to repair ear drum hole/perforation called Tympanoplasty is required.
• This procedure is done under general anaesthesia and surgeons uses a small patch of fascia (muscle sheath) or perichondrium (covering of cartilage) to repair the perforation.
• Endoscopic Ear Surgery (EES) is the ideal way of performing Tympanoplasty and is preferred approach by Dr. Kapadia as it avoids taking any visible external incision and scars.
• If there is any associated ear bone damage (ear ossicles erosion), then surgeon will also perform repair of the ossicular chain known as Ossiculoplasty.
• This surgery usually lasts for 1-2 hours, and patient gets discharge from the hospital on the same day.