Diagnosis
Eardrum Perforation — Causes and Consequences
The eardrum is a thin membrane that separates the external and middle ear. It transmits and amplifies sound in the form of vibrations that are passed on to the ossicles and into the inner ear. Its integrity gives us good hearing, while at the same time protecting us from infections. Eardrum perforations can result from infection, trauma or previous eardrum surgery. Perforations may be acute or chronic, and symptoms vary depending on the size, position and associated pathological conditions of the middle ear.
Infection is one of the main causes of eardrum perforation. Acute middle ear inflammation can cause the eardrum to rupture and most commonly heals after the infection has resolved. Chronic middle ear inflammation with perforation, on the other hand, may be associated with chronic ear discharge or cholesteatoma, and such conditions will not heal without surgical intervention. Traumatic perforations are caused by blows to the ear, strong atmospheric overpressure, exposure to excessive water pressure (e.g. in divers), and improper attempts to remove wax or clean the ears.
A damaged eardrum can cause various problems:
- Reduction in hearing quality — hearing loss due to reduced ability of the eardrum to vibrate
- Ear discharge and drainage
- Recurrent ear pain and infections
- Increased susceptibility to water and infections
- If untreated: dangerous complications such as meningitis, brain abscess, deafness, facial nerve paralysis
Smaller acute perforations most often heal on their own. If a perforation persists for more than three months, it is considered chronic and surgical treatment is required. The operation for reconstruction of the eardrum is called myringoplasty, or tympanoplasty if intervention on the ossicles is also required.
