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The perforated tympanic membrane.

B J Davidson1, M S Morris

  • 1Georgetown University School of Medicine, Washington, D.C.

American Family Physician
|April 1, 1992
PubMed
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Tympanic membrane perforations from trauma or infection usually cause mild hearing loss. Most small perforations heal on their own, but significant issues may require medical attention.

Area of Science:

  • Otolaryngology
  • Audiology

Background:

  • Tympanic membrane perforations commonly stem from trauma or acute otitis media.
  • Most perforations result in mild conductive hearing loss, aural fullness, and tinnitus.

Purpose of the Study:

  • To outline the evaluation and management of tympanic membrane perforations.
  • To identify indicators for potential complications and the need for specialist referral.

Main Methods:

  • Clinical examination including suctioning of the ear canal and description of perforation.
  • Patient history assessment for vertigo, nausea, and vomiting.
  • Audiometry to quantify hearing loss; imaging (radiographs, CT scans) for complex cases.

Main Results:

  • Conductive hearing loss over 30 dB or sensorineural loss suggests ossicular chain or inner ear damage.

Related Experiment Videos

  • Small perforations often resolve spontaneously with conservative management.
  • Complicated cases may involve the ossicular chain, inner ear, or chronic infection.

    • Conclusions:

    • Conservative management (keeping the ear dry, antibiotics if needed) is appropriate for most tympanic membrane perforations.
    • Referral to otolaryngology is indicated for traumatic perforations with significant symptoms, chronic perforations, or non-healing acute perforations.