Eardrum injuries ( also: eardrum perforation, eardrum rupture ) include ruptures (cracks) and perforations (holes) in the tympanic membrane. Injuries to the eardrum are usually due to inflammation of the middle ear (otitis media) or direct or indirect trauma.
What are eardrum injuries?
An eardrum injury is a rupture or perforation in the so-called tympanic membrane (eardrum), which protects the middle ear from external influences as a thin membrane. Injuries to this membrane manifest themselves in the form of stabbing pain in the area of the ear (particularly in the case of a ruptured eardrum), impaired hearing, slight bleeding in the ear in the event of a ruptured eardrum and possibly purulent otorrhea ( flow in the ears ) in the event of a perforated eardrum. For medullary cystic kidney disease type 1 definition and meaning, please visit eshaoxing.info.
Pathogens or foreign bodies that have penetrated the damaged areas of the eardrum can also cause otitis media ( inflammation of the middle ear ) and lead to inflammatory reactions. This can result in dizziness, nausea, vomiting, pounding noises in the ears ( tinnitus ) and nystagmus ( shaking eyes ). Furthermore, an eardrum injury with an irritated inner ear can in some cases cause paralysis of the facial nerve (nervus facialis).
Injuries to the eardrum are usually due to barotrauma (detonations, blows to the ear with the palm of your hand, disturbed pressure equalization when flying or diving), direct damage to the membrane by sharp or blunt objects (cotton swabs, hairpins), infections (otitis media) or iatrogenic causes (improperly performed ear irrigation).
A greater impact on the ear can also lead to damage to the middle ear (injury to the auditory ossicles) and possibly the inner ear. In addition, burns (beads of sweat) and chemical burns can damage the tympanic membrane.
A longitudinal petrous bone fracture (form of a skull base fracture) is also often associated with a rupture of the eardrum. If the eardrum has already been injured, the risk of another rupture or perforation is increased.
Symptoms, Ailments & Signs
An eardrum injury usually affects only one ear. The fact that both hearing organs are attacked to the same extent is an exception. In addition to acute symptoms, consequential damage can occur if treatment is too late or omitted. The most common symptom is a pain in the ear. This occurs during or shortly after the injury.
However, it goes out after a few seconds. In rare cases, it is accompanied by a small amount of bleeding from the ear. An acute illness usually causes small tears in the eardrum. Affected persons then perceive no recognizable hearing loss. If, on the other hand, damage occurs to the auditory ossicles, permanent hearing loss is possible.
In addition to the direct symptoms in the ear, the body sometimes reacts with other complaints. Those affected then complain of dizziness. Sometimes there is also nausea. The eyes move back and forth quickly. In the case of extensive injuries, doctors regularly diagnose a middle ear infection. Facial paralysis can also occur.
An eardrum injury can lead to permanent hearing damage. For example, patients no longer understand conversations clearly in a noisy environment. Constant ringing in the ears is part of everyday life. In the worst case, this reduction in hearing ability can develop into deafness.
Diagnosis & History
In many cases, a suspicion of an injury to the eardrum results from the anamnesis and the description of the course of the accident and the specific symptoms present. The diagnosis is confirmed within the framework of an otoscopy ( earscopy ) and/or ear microscopic examination. A hearing test enables statements to be made about an existing conductive hearing loss (hearing impairment), impairments of the inner and middle ear and damage to the auditory ossicles.
If the injury resulted from violent impact with objects or liquid metal, an X-ray may be needed to locate any residual debris or debris.
As a rule, eardrum ruptures and perforations have a good prognosis and heal without complications. Severe injuries to the eardrum involving the inner and/or middle ear can lead to irreversible hearing loss or deafness.
Direct injuries to the eardrum can damage the auditory ossicles. It is responsible for transmitting sound from the eardrum to the inner ear. A dislocation of the ankle is also not uncommon. This is a joint injury that often leads to a tear in the joint capsule.
This severely limits hearing, which often results in deafness. Inflammation of the middle ear is one of the most common complications: if it is acute, it is particularly painful as it progresses and leads to pulsation, throbbing and ringing in the ears, which further impairs hearing. Fever, nausea and vomiting occur with a more severe course of inflammation.
There is also a risk of perforation of the medial wall of the tympanic cavity, the cavity in the middle ear that is just behind the eardrum. It is responsible for equalizing the pressure in the ear. It is not uncommon for meningitis to occur when the tympanic cavity has been affected. Bacteria, viruses and fungi settle in the injured tissue and this can lead to cramps, photophobia and apathy.
Labyrinthitis is also often the result. The labyrinth of the inner ear becomes inflamed and the entire duct system is adversely affected. In the worst case, pus forms, which leads to deafness in severe cases.
When should you go to the doctor?
In the event of an injury to the eardrum, a doctor should always be consulted. If pain occurs in the area of the ear canal or hearing suddenly deteriorates, medical advice is required. If blood runs out of the ear canal, it is best to see an audiologist immediately. An injury to the eardrum must be clarified and treated in order to avoid restrictions in everyday life and to rule out complications such as an infection of the middle ear. Increasing ear pain or purulent discharge in the area of the ear indicate an injury that needs to be examined. If the symptoms occur after attending a concert, the eardrum may have ruptured.
The ear doctor can diagnose the condition with the help of an otoscope and arrange for further measures. This should be done as early as possible to avoid further deterioration of hearing. If the eardrum is damaged in an accident, the emergency services must be called. The ears can be carefully cleaned beforehand. People who put a lot of strain on their ears and auditory canals should see a specialist at regular intervals.
Treatment & Therapy
The therapeutic measures for injuries to the eardrum depend on the severity of the damage. Small injuries usually heal on their own within a few days without the need for treatment.
During the convalescence phase, however, the affected ear should be kept dry, for example by protecting it with an ear bandage or cotton wool cream while showering or bathing. If an eardrum perforation is diagnosed as a result of otitis media, decongestant nose and/or ear drops and antibiotics are also used. If an eardrum rupture is characterized by rolled-up or rolled-up injury edges, these are tightened and the affected eardrum splinted with a silicone film to ensure that the edges grow together smoothly.
If the injury has not healed after a few weeks (4 to 6), surgical closure is required to restore sound conductivity. For this purpose, the natural shape of the eardrum is reconstructed as part of a myringoplasty by replacing the defects in the ruptured or perforated eardrum with adjacent tissue (fascia, cartilage, cartilage skin).
Smaller defects can be replaced by the body’s own fatty tissue if necessary. As a rule, injuries to the middle and/or inner ear (damage to the auditory ossicles) can be repaired (tympanoplasty) at the same time as part of this procedure. After the reconstruction, the eardrum is stabilized using a silicone foil.
An eardrum injury cannot be prevented in every case. However, proper hearing protection can prevent barotrauma from blasts. Injuring the eardrum can also be avoided by not cleaning the ear canal with cotton swabs or other pointed objects.
If you have a cold or otitis media before a flight or a dive, you should avoid this. The so-called Valsalva maneuver (forced exhalation with a closed nose and mouth) minimizes the risk of an eardrum injury during take-off and landing when traveling by plane.
Eardrum injuries can regenerate well with consistent aftercare. Competent contacts in this context are the ENT doctor or the hearing aid acoustician. A doctor’s check-up gives you the certainty that the injury is healing optimally. The doctor determines the frequency and cycle of the check-ups.
The patient is also responsible for the success of the aftercare with his cooperation. It is important to avoid putting pressure on the eardrum during the healing phase in order to prevent it from rupturing again. Diving is a sport to avoid due to the pressure on the eardrum during the follow-up phase. Air travel can also overload the eardrum and should be undertaken in consultation with the doctor.
In order to prevent particles from getting into the ear canal and contaminating it if the eardrum is leaking, protective measures are also advisable during aftercare. So when washing your hair and showering, no water with shampoo residue should get into your ears. Anyone who hears badly due to an eardrum injury or has tinnitus as a symptom should be patient and not overwhelm themselves professionally or privately during the aftercare period.
Those who prefer to read a book in peace and do without music can often support the regeneration of eardrum injuries in the long term. Anyone who suspects hearing damage can easily clarify this with a hearing aid acoustician with a hearing test.
You can do that yourself
Mild illnesses usually do not require further treatment. Small cracks close by themselves. Those affected benefit from the self-healing power of the eardrum. However, you can support recovery by taking it easy and avoiding loud ambient noise.
In addition, the ear must be kept dry. When showering, it is advisable to use moisture-repellent cotton wool. Shampoos should not get into the ear canal. They can reopen wounds due to the substances they have received. Self-help measures are generally not advisable if complications such as blood flow, pain or hearing loss occur. Patients can use over-the-counter nasal drops to speed recovery. This improves the ventilation of the ear canal. A pharmacist will advise you on suitable preparations. In addition, sports should be avoided after an acute illness. Patients should not lie on the diseased ear at night. In winter, a hat or headband should be worn when taking walks in the fresh air.
Eardrum injuries particularly affect workers in noisy environments. You should definitely use hearing protection. This preventative measure is the best way to prevent disease. The employer is obliged to provide protective equipment.