Rupture Eardrum
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Ruptured Eardrum
A ruptured eardrum (tympanic membrane perforation) is a hole or tear in the thin tissue that separates the ear canal from the middle ear (eardrum).
A ruptured eardrum can result in hearing loss. It can also make the middle ear vulnerable to infections.
A ruptured eardrum usually heals within a few weeks without treatment. But sometimes it requires a patch or surgical repair to heal.
⭕ Symptoms
Signs and symptoms of a ruptured eardrum may include:
• Ear pain that may subside quickly
• Mucuslike, pus-filled or bloody drainage from the ear
• Hearing loss
• Ringing in the ear (tinnitus)
• Spinning sensation (vertigo)
• Nausea or vomiting that can result from vertigo
⭕ Causes
Causes of a ruptured (perforated) eardrum may include:
• Middle ear infection (otitis media). A middle ear infection often results in the accumulation of fluids in the middle ear. Pressure from these fluids can cause the eardrum to rupture.
• Barotrauma. Barotrauma is stress exerted on the eardrum when the air pressure in the middle ear and the air pressure in the environment are out of balance. If the pressure is severe, the eardrum can rupture. Barotrauma is most often caused by air pressure changes associated with air travel.
Other events that can cause sudden changes in pressure — and possibly a ruptured eardrum — include scuba diving and a direct blow to the ear, such as the impact of an automobile air bag.
• Loud sounds or blasts (acoustic trauma). A loud sound or blast, as from an explosion or gunshot — essentially an overpowering sound wave — can rarely cause a tear in the eardrum.
• Foreign objects in your ear. Small objects, such as a cotton swab or hairpin, can puncture or tear the eardrum.
• Severe head trauma. Severe injury, such as a skull base fracture, may cause the dislocation of or damage to middle and inner ear structures, including the eardrum.
⭕ Complications
The eardrum (tympanic membrane) has two primary roles:
• Hearing. When sound waves strike it, the eardrum vibrates — the first step by which structures of the middle and inner ears translate sound waves into nerve impulses.
• Protection. The eardrum also acts as a barrier, protecting the middle ear from water, bacteria and other foreign substances.
If the eardrum ruptures, uncommon problems can occur, especially if it fails to self-heal after three to six months. Possible complications include:
• Hearing loss. Usually, hearing loss is temporary, lasting only until the tear or hole in the eardrum has healed. The size and location of the tear can affect the degree of hearing loss.
• Middle ear infection (otitis media). A ruptured (perforated) eardrum can allow bacteria to enter the ear. If a perforated eardrum doesn't heal, a small number of people may be vulnerable to ongoing (recurrent or chronic) infections. In this small group, chronic drainage and hearing loss can occur.
• Middle ear cyst (cholesteatoma). Although very rare, this cyst, which is composed of skin cells and other debris, can develop in the middle ear as a long-term result of eardrum rupture.
Ear canal debris normally travels to the outer ear with the help of ear-protecting earwax. If the eardrum is ruptured, the skin debris can pass into the middle ear and form a cyst.
A cyst in the middle ear provides a friendly environment for bacteria and contains proteins that can damage the bones of the middle ear.
Ruptured Eardrum
A ruptured eardrum (tympanic membrane perforation) is a hole or tear in the thin tissue that separates the ear canal from the middle ear (eardrum).
A ruptured eardrum can result in hearing loss. It can also make the middle ear vulnerable to infections.
A ruptured eardrum usually heals within a few weeks without treatment. But sometimes it requires a patch or surgical repair to heal.
⭕ Symptoms
Signs and symptoms of a ruptured eardrum may include:
• Ear pain that may subside quickly
• Mucuslike, pus-filled or bloody drainage from the ear
• Hearing loss
• Ringing in the ear (tinnitus)
• Spinning sensation (vertigo)
• Nausea or vomiting that can result from vertigo
⭕ Causes
Causes of a ruptured (perforated) eardrum may include:
• Middle ear infection (otitis media). A middle ear infection often results in the accumulation of fluids in the middle ear. Pressure from these fluids can cause the eardrum to rupture.
• Barotrauma. Barotrauma is stress exerted on the eardrum when the air pressure in the middle ear and the air pressure in the environment are out of balance. If the pressure is severe, the eardrum can rupture. Barotrauma is most often caused by air pressure changes associated with air travel.
Other events that can cause sudden changes in pressure — and possibly a ruptured eardrum — include scuba diving and a direct blow to the ear, such as the impact of an automobile air bag.
• Loud sounds or blasts (acoustic trauma). A loud sound or blast, as from an explosion or gunshot — essentially an overpowering sound wave — can rarely cause a tear in the eardrum.
• Foreign objects in your ear. Small objects, such as a cotton swab or hairpin, can puncture or tear the eardrum.
• Severe head trauma. Severe injury, such as a skull base fracture, may cause the dislocation of or damage to middle and inner ear structures, including the eardrum.
⭕ Complications
The eardrum (tympanic membrane) has two primary roles:
• Hearing. When sound waves strike it, the eardrum vibrates — the first step by which structures of the middle and inner ears translate sound waves into nerve impulses.
• Protection. The eardrum also acts as a barrier, protecting the middle ear from water, bacteria and other foreign substances.
If the eardrum ruptures, uncommon problems can occur, especially if it fails to self-heal after three to six months. Possible complications include:
• Hearing loss. Usually, hearing loss is temporary, lasting only until the tear or hole in the eardrum has healed. The size and location of the tear can affect the degree of hearing loss.
• Middle ear infection (otitis media). A ruptured (perforated) eardrum can allow bacteria to enter the ear. If a perforated eardrum doesn't heal, a small number of people may be vulnerable to ongoing (recurrent or chronic) infections. In this small group, chronic drainage and hearing loss can occur.
• Middle ear cyst (cholesteatoma). Although very rare, this cyst, which is composed of skin cells and other debris, can develop in the middle ear as a long-term result of eardrum rupture.
Ear canal debris normally travels to the outer ear with the help of ear-protecting earwax. If the eardrum is ruptured, the skin debris can pass into the middle ear and form a cyst.
A cyst in the middle ear provides a friendly environment for bacteria and contains proteins that can damage the bones of the middle ear.
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تمزق طبلة الأذن (طبلة الأذن المثقوبة)
⭕ التشخيص
يمكن للطبيب أو اختصاصي الأذن والأنف والحنجرة في أغلب الأحيان تحديد إذا ما كنت مصابًا بتمزق طبلة الأذن عن طريق الفحص البصري باستخدام أداة مزودة بإضاءة (مجهر أو منظار الأذن). وقد يجري الطبيب اختبارات إضافية (أو يطلب منك إجراؤها) لتحديد سبب أعراض أذنك أو الكشف عن أي فقد في السمع. ومن هذه الاختبارات ما يلي: • الاختبارات المعملية. في حالة وجود إفرازات من الأذن، قد يطلب الطبيب إجراء اختبار معملي أو مزرعة للكشف عن العدوى البكتيرية في الأذن الوسطى. • تقييم الشوكة الرنانة. الشوكات الرنانة عبارة عن أدوات معدنية ذات شقين تنتج أصواتًا عند ضربها. إجراء الاختبارات البسيطة باستخدام الشوكات الرنانة قد يساعد الطبيب في الكشف عن أي فقد في السمع. قد يكشف تقييم الشوكة الرنانة أيضًا عما إذا كان فقد السمع بسبب تلف الأجزاء المهتزة في الأذن الوسطى (بما في ذلك طبلة الأذن)، أو تلف المستشعرات أو الأعصاب في الأذن الداخلية، أو تلف كليهما. • قياس الطبل. يستخدم قياس الطبل جهازًا يدخل في قناة الأذن لقياس استجابة طبلة الأذن للتغيرات الطفيفة في ضغط الهواء. قد تدل أنماط معينة من الاستجابة على وجود ثقب في طبلة الأذن. • اختبار سمع. هو سلسلة من الاختبارات تقيس مدى كفاءة سماعك للأصوات بمستويات وطبقات مختلفة. وتجرى الاختبارات داخل غرفة عازلة للصوت.
⭕العلاج
معظم طبلات الأذن الممزَّقة (المثقوبة) تلتئم من تلقاء نفسها دون علاج خلال بضعة أسابيع. قد يصف الطبيب مضادًّا حيويًّا على شكل نقط في حالة وجود دليل على العدوى. فإذا كان التمزُّق أو الثقب في طبلة الأذن لا يلتئم من تلقاء نفسه، فمن المرجَّح أن يشمل العلاج إجراءات جراحية لإغلاق التمزُّق أو الثقب. وقد تشمل ما يلي:
• لصيقة طبلة الأذن. إذا لم يلتئم التمزُّق أو الثقب في طبلة الأذن من تلقاء نفسه، فقد يُغلِقه اختصاصي الأنف والأذن والحنجرة بلصيقة ورقية (أو لصيقة مصنوعة من مادة أخرى).
في هذا الإجراء البسيط "الذي يتم في العيادة الخارجية"، قد يضع طبيب الأنف والأذن والحنجرة مادة كيميائية على حواف الثقب، والتي يُمكن أن تُعزِّز التئام طبلة الأذن، ومن ثم يضع لصيقة على الثقب. قد يحتاج الإجراء لتكراره أكثر من مرة قبل الْتِئام الثقب.
• الجراحة. إذا لم تُؤَدِّ اللَّصيقة الجلدية إلى الالتئام الجيد، أو في حالة تقرير طبيب الأنف والأذن والحنجرة أن الثقب لن يلتئم بعد استخدام اللصيقة، قد يُوصي/ تُوصي بالجراحة.
ويسمي الإجراء الجراحي الأكثر شيوعًا رأب الطبلة. يقوم الجرَّاح بترقيع لَصيقة من أنسجتك؛ لإغلاق الثقب الموجود في طبلة الأذن. يتمُّ هذا الإجراء في العيادة الخارجية. عند الخضوع لإجراء في العيادة الخارجية، يمكنك عادةً الذهاب إلى المنزل في اليوم ذاته ما لم تتطلَّب ظروف التخدير الطبي إقامةً أطول في المستشفى.
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Dr. Mohsen Rajati Haghi, MD
Otologist, Neurotologist, Full Professor
Baran bld, Aref 5, Ahmadabad Ave., Mashhad, iran
0098-5138473541
0098-9156011229
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Follow us on Instagram: @drrajatihaghi