Does otitis media with tympanic membrane perforation require surgery?

Eardrum perforation is a type of middle ear trauma, and there are two main types of tympanic perforation caused by otitis media: acute and chronic. Many people are not sure whether tympanic membrane perforation caused by otitis media requires surgery. Because otitis media and tympanic membrane perforation cannot be cured, surgery is the best treatment.

1. For tympanic membrane perforation caused by various acute and chronic otitis media, doctors will use different surgical repair methods depending on the size and location of the perforation, the degree of hearing loss, and whether there are granulations, polyps, and cholesteatoma in the middle ear cavity. The simplest repair methods, such as burning patches and stimulation therapy, can usually be completed in outpatient clinics.

2. Generally, traumatic perforation (rupture) of the tympanic membrane does not require immediate surgery. The doctor will use 75% alcohol to disinfect the external auditory canal several times and leave a cotton ball at the opening of the external auditory canal. However, patients should be careful not to let water enter the ears when washing their hair daily and keep the external auditory canal dry. Patients should also not drop medicine into the ears to prevent endogenous bacteria in the external auditory canal from entering the middle ear and causing secondary infection. If there is no secondary infection, traumatic tympanic membrane perforation (rupture) can heal on its own in about 1 month, and hearing will return to normal. If the perforation does not heal after more than one month of observation, or if conductive hearing loss remains, surgical treatment should be considered.

3. In addition to causing ear leakage and hearing impairment, the perforation of the eardrum caused by otitis media also poses a risk of forming cholesteatoma, so it is necessary to repair it. A ruptured eardrum can be repaired using the fascia of the temporal muscle next to the ear, with a success rate of over 90%. This myringoplasty or tympanoplasty can eliminate ear leakage and improve hearing. The anesthesia method for eardrum perforation repair surgery can be local anesthesia or general anesthesia, depending on the patient's condition. This type of surgery is a more sophisticated microsurgical method. If the eardrum perforation is combined with cholesteatoma, the treatment is much more complicated than simple eardrum perforation repair. Sometimes mastoid surgery or ossicular chain reconstruction surgery is required.