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Dr. Lakshmi Ponnathpur, MS - ENT MBBS | Phone 📞 080 2663 1108 (Online & in-person appointment can be booked online or by call) Consultant ENT Surgeon | Skin, Cosmetic & ENT Care Center, Bangalore, India
Ruptured ear drum or a perforated eardrum generally results from two factors. One is from trauma, another is from disease. So when a ruptured drum happens we call it as a traumatic perforation. The commonest reason for this being a slap injury on the face, on the temple. It's very common to find siblings fighting, teacher hitting the child or the parents hitting the child and friends fighting or even a friendly pat by the husband and wife all these factors can lead to a ruptured drum. Eardrum is wedge between the external ear and the middle ear and sudden forceful slap injury or any bump on the head with any object or dashing head injury can result in ruptured tympanic membrane. The second reason for a ruptured drum is a untreated case of acute suppurative otitis media or a middle ear infection. In middle ear there is a small space and when it is severely infected in that small space lot of pus accumulates and if the pressure is not relieved with adequate antibiotics and decongestants then the only way for the pus to come out is by rupturing. The drum ruptures and the pus starts coming out. So ruptured drum can happen through following an acute infection and if it is not treated adequately the condition progresses to a condition called CSOM which means Chronic Suppurative Otitis Media. The perforated drum continues to be there and it continues to leak on and off whenever water goes into the ear or whenever the person or the child has a upper respiratory infection or a middle ear infection. So these are the conditions causing perforated eardrum. The treatment wise traumatic perforation generally heals by itself no need to do anything you just observe the patient periodically, tell them to avoid a head bath and any kind of instillation of medicines into the ear, self-medication such as oil etc. should be strictly avoided. Patient has to keep the ear totally dry and clean and they should come and visit the ENT specialist once in a week so that we follow the progress of healing. If it does not heal within three weeks then we have to do what is called a PRF grafting. We have to do a myringoplasty using a platelet-rich fibrin material which is obtained from the patient's own blood. If the perforation persists after even a infection is cured in the ASOM if the perforation is still there we have to advise surgery because otherwise the patient will suffer from conductive hearing loss. The treatment for a perforated drum in a chronic suppurative otitis media is also a surgery in the form of tympanoplasty. We have to eradicate the disease from the middle ear and then reconstruct the hearing mechanism by the operation tympanoplasty where we reconstruct the eardrum as well as the middle ear ossicles. Thank you.
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