GNM II YEAR MSN II

1. PERFORATION OF THE
EAR DRUM

2. DEFINITION
• CHRONIC INFECTION OF THE
MUCOPERIOSTEAL LINING OF
THE MIDDLE EAR CLEFT,
WHICH IS CHARACTERISED BY
•DISCHARGE, DEAFNESS,
PERFORATION OF THE
TYMPANIC MEMBRANE.

3. TYPES
 PERMANENT PERFORATION
SYNDROME
[Lille type 1]
 PERSISTANT MUCOSAL
DRAINAGE [ Lille TYPE 2]

4. ETIOLOGY
 Sequelae of acute suppurative
otitis media
 permanent perforation , entry
of infection through Eustachian
tube and external auditory
meatus
 traumatic perforation

5. PREDISPOSING FACTOR
 INFECTION FROM TONSILS,
ADENOIDS AND SINUSES
ALLERGY
EUSTACHIAN TUBE
DYSFUNCTION
MALNUTRITION
BATHING AND SWIMMING IN
DIRTY WATER.

6. CLINICAL MANIFESTATION
 perforation of tm
 mucosa of middle ear may be
odematous or congested
polyps usually pale
 kidney shaped perforation
ET tube opening, round
window, ossicles seen

7. FUNCTIONAL EXAMINATION
o tuning fork test
opure tone audiometry
ohaemoglobin
oTotal leuko cyte count
oBleeding time
oClotting time
oUrine routine, culture of ear
discharge, x rays

8. MANAGEMENT
• ACTIVE STAGE:
 aural cleaning by dry method, wet method
and syringing with warm saline
Antibiotic a combination of amoxy-clox and
ciprotinidazole
Decongestant and antiallergics
INACTIVE STAGE:
Perforation less than 5mm size: cautery with
trichloro acetic acid or silver nitrate.
Gel foam
•