What to do if the tympanic membrane is traumatically ruptured?

Generally speaking, the chances of the eardrum being injured are relatively small because it is located in a relatively hidden location, deep in the external auditory canal. However, due to its fragile structure, it can be easily damaged after being attacked, such as by concussion, which can easily cause infection. Therefore, it must be taken seriously and not left untreated, and allowed to heal on its own. What should I do if the eardrum is ruptured traumatically?

When the eardrum is injured, you should go to the hospital for an electronic otoscope examination in time, and if necessary, an ear endoscope examination to clarify the nature of the eardrum injury. Use 75% alcohol to gently wipe the external auditory canal several times, keep the external auditory canal dry, and leave a cotton ball. Do not drop anti-inflammatory drugs into the ear to prevent endogenous bacteria in the external auditory canal from entering the middle ear and causing secondary infection. If there is no middle ear infection, the traumatic eardrum rupture can heal on its own in about a month, and hearing will return to normal. If the eardrum perforation has healed but conductive deafness remains, follow up for 2-3 months and go to the "Clinical Hearing Center" for relevant audiological examinations. If the hearing does not improve, surgical treatment should be considered.

Principle: Prevent infection and promote perforation healing

1. Before the hole heals: Do not swim or put any liquid into the ear, including external ear canal irrigation or ear drops

2. Patients with suppurative infection: treat as suppurative otitis media

3 If there is no secondary infection, the perforation will heal on its own within 2-4 weeks. If it is larger and does not heal for a long time, tympanoplasty can be performed. Avoid swimming or letting any liquids enter your ears until the piercing has healed. Most traumatic perforations can heal on their own within 3 to 4 weeks. Larger and longer-lasting perforations may require tympanoplasty.

As long as there is no secondary infection and the area of ​​the hole is not too large, the eardrum perforation caused by trauma will usually heal on its own in about a month and no additional treatment is required. In addition to causing ear leakage and hearing impairment, tympanic membrane perforation in chronic 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 tympanic membrane 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 tympanic membrane perforation is combined with cholesteatoma, the treatment is much more complicated than simple tympanic membrane perforation repair. Sometimes, mastoid surgery or ossicular chain reconstruction surgery is required.

The causes of eardrum perforation are either accidents or pathological changes. Repair surgery is one of the most common ENT surgeries in our medical center hospital. It has a high success rate and can both solve the perforation and improve hearing, killing two birds with one stone.

Treatment of perforation that fails to heal

(1) The cauterization patch method uses 30% silver nitrate or 50% trichloroacetic acid to burn the edge of the perforation to make it a fresh wound surface, and then a thin sheet, such as plastic film or garlic film, is applied. The new tissue grows along the patch toward the center and generally heals within a few weeks.

(2) Stimulation therapy: scrape the epithelium at the edge of the perforation to promote tissue regeneration, and then drip 5% urea boric acid solution to accelerate repair.

(3) If the above treatments fail, surgery can be used to repair the perforation. Currently, the body’s own perichondrium, fascia, etc. are often used as repair materials.

Patients should not rinse the ear canal with water, as it is very dangerous. They should also not apply medicine, as this will not do any good and may cause infection. Add or remove clothes in time to prevent colds. Do not blow your nose hard. If you have mucus, you can inhale it through your mouth and spit it out. You can also take some anti-inflammatory drugs to prevent infection.