This document discusses tympanic membrane perforation, also known as a ruptured eardrum. It can be caused by direct force trauma to the ear such as from wax removal or skull fractures, or indirect force from barotrauma or increased violence/firearms. Infection of the middle ear from bacteria, viruses or fungi can also cause a perforation. Symptoms include ear pain, fullness, discharge from the ear, hearing loss, vertigo, and tinnitus. Diagnosis involves history, physical exam, otoscopic exam, and audiogram. Treatment involves antibiotics to prevent infection, keeping the ear canal clean, avoiding nose blowing or ear drops, and surgery if not healed after 3 months. S

1. TYMPANIC MEMBRANE
PERFORATION
ANILKUMAR BR
MSC. N
LECTURER (MSN)

2. Definition
TMP it is a condition of rupture or
perforation of the ear drum.

3. Causes
• DIRECT FORCE
.e.g Caress while removal wax
skull fracture max tear TM
Hot slag in to the ear

4. Indirect force
• Increase in violence and fire arms
• barotrauma

5. Causes of TMP
• Foreign bodies usually pointed objects
• Infection of the middle ear can cause
ruptured ear drum (it can caused by
bacteria, virus and fungi)
• Trauma the ear drum and causing pain

6. Clinical manifestations
• Otalgia (pain in the ear)
•Fullness, discomfort
•Blood tinged discharge from the ear
•Hearing loss (conductive HL) or Mixed HL
•Vertigo
• Tinnitus (Ringing)

7. Diagnostic evaluation
• History collection and physical
examination
• Otoscopic examination
• Tympanogram
•Audiogram or audiometry test

8. Management
• Antibiotics therapy to prevent infection
• Aseptic external auditory canal with alcohol
• Prevent super respiratory infection
• Prohobit Nasal blow
• Probhit ear drops
• It takes 3-4 weeks to heal the ear drum
• If three months later perforation still exists
Myringoplasty is indicated

9. Surgical management
• Tympanoplasty ( it is the surgical
correction of the perforated ear drum.
Is performed under local anesthesia, an
incision may be made behind the ear or
entirely through the ear canal.
Depending on the location and size of
the TMP)

10. Myringoplasty
•Closure of perforation is called
Myringoplasty

11. Ossiculoplasty
•Ossicular reconstruction is called
ossiculoplasty