Ear Perforation/Hole in the Eardrum/Ruptured Eardrum
The ear is divided into the outer, middle, and inner ear. Sound waves enter the outer ear and cause the eardrum to vibrate. These vibrations are then transmitted through the middle ear’s tiny bones to the cochlea in the inner ear, which converts them into sound signals sent to the brain.
What is a Hole in the Eardrum?
A hole in the eardrum, known as a “perforation,” can occur due to infection or injury to the eardrum. Acute traumatic perforations often heal on their own, but they can cause discharge from the ear and reduced hearing. In some cases, they can also damage the bones in the ear.
Causes of Eardrum Perforation:
Injury to the ear from using earbuds or sharp objects for cleaning
Middle ear infections
Barotrauma, such as while scuba diving or during flights when the air pressure fails to equalize on both sides of the eardrum
Exposure to sudden loud noises, like explosions, leading to shock waves
Symptoms of Eardrum Perforation:
Hearing loss, ranging from muffled sounds to significant loss, depending on the size of the perforation
Tinnitus (ringing in the ear)
Ear pain
Itching in the ear
Pus discharge
Diagnosis:
An ENT specialist examines the ear using an otoscope to identify the perforation. If the hole is covered by wax or discharge, it may require cleaning and a follow-up examination. Hearing tests are conducted to assess the extent of hearing loss and to check for damage to the middle or inner ear.
Treatment of Eardrum Perforation:
Recent perforations may heal on their own within three months. In cases of infection, antibiotics may be prescribed. It is important to avoid water entering the ear, and the use of earbuds or cotton-tipped devices should be avoided. If the perforation does not heal within three months, surgery may be required. A patch test may be performed to assess hearing loss caused by the perforation.
Aims of the Surgery:
Closing the perforation has several benefits, including preventing water from entering the middle ear during activities like showering, bathing, or swimming, which could cause ear infections. Mastoid surgery may be performed concurrently in some cases.
Details of the Surgery:
Myringoplasty or tympanoplasty can be performed under general or local anesthesia. A graft taken locally from behind or above the ear is used to patch the eardrum and is placed against it. Ointment-soaked gauze may be placed in the ear canal, and in some cases, external dressing may be required. The success of the surgery depends on the size of the perforation