Tympanic membrane perforation

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Tympanic membrane perforation

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Tympanic membrane perforation

  1. 1. TYMPANIC MEMBRANE PERFORATION
  2. 2. Etiology  Direct force  Careless while removal wax by himself or herself  Skull fracture may tear TM  Hot slag fly into the ear  Indirect force  Increase in violence and firearms  Barotrauma
  3. 3. Associated complications Is usually associated with TM or inner ear trauma unless Iatrogenic  Ossicular discontinuity  Facial Nerve Injury  Chorda tympani Nerve Injury  Barotrauma to Stapes footplate
  4. 4. Clinical manifestations  Otalgia  Bleeding  Fullness  Hearing loss: conductive HL or mixed HL  Tinnitus  Shape of perforation is split
  5. 5. Physical examination  Tympanic perforation  Central perforation  Marginal perforation  Blood crust  If skull base fracture is occurred with CSF leakage, clear fluid is observed.
  6. 6. Diagnosis  Otoscopic examination  The audiometry can provide useful informations.  Conductive Hearing loss > 40db suspicion for ossicular discontinuity  Hearing test reveals sensori-neural Hearing Loss, it means inner ear injury
  7. 7. Management  Antibiotic to prevent infection  Aseptic external auditory canal with alcohol  Prevent super respiratory infection  Prohibit nasal blow  Prohibit ear drops  It takes 3-4 weeks to heal the ear drum  If 3 months later, perforation still exists, myringoplasty is indicated.
  8. 8. Preventions  Be caution while removing your wax  Using ear plug
  9. 9. The End

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