The difference between perforation of old otitis media and traumatic perforation of the tympanic mem

Hello: Old eardrum perforation, the eardrum is not congested or chronically hyperemic, and the perforated margin is smooth and regular. The key points for the diagnosis of traumatic tympanic membrane perforation are:

History of ear or head injury; with earache, deafness, and minor bleeding in the external auditory canal; The morphology conforms to the characteristics of traumatic perforation: the perforation is mostly located in the tense part, which is fissure-shaped, triangular, irregular, etc., and the perforated edge is sharp, eversion, and attached to the blood crust; Acoustic conductance test does not elicit tympanogram, or the injured ear has a B-shaped curve but the volume of the external auditory canal is significantly larger than that of the healthy ear; Exclude perforation due to otitis media.

Guidance: Fresh eardrum perforation, the eardrum is mostly acutely hyperemic, a little blood can be seen at or near the perforation margin, and the perforated margin is not smooth and regular. A physician's diagnosis is recommended to distinguish between old or traumatic tympanic membrane perforation.

Analysis: old eardrum perforation, the eardrum is not congested or chronically hyperemic, and the perforation margin is smooth and regular. The key points for the diagnosis of traumatic tympanic membrane perforation are:

History of ear or head injury; with earache, deafness, and minor bleeding in the external auditory canal; The morphology conforms to the characteristics of traumatic perforation: the perforation is mostly located in the tense part, which is fissure-shaped, triangular, irregular, etc., and the perforated edge is sharp, eversion, and attached to the blood crust; Acoustic conductance test does not elicit tympanogram, or the injured ear has a B-shaped curve but the volume of the external auditory canal is significantly larger than that of the healthy ear; Exclude perforation due to otitis media. Guidance:

Fresh eardrum perforation, the eardrum is mostly acutely hyperemic, a little blood can be seen at or near the perforation margin, and the perforated margin is not smooth and regular. A physician's diagnosis is recommended to distinguish between old or traumatic tympanic membrane perforation.

a.The body temperature rises sharply.

b.Earache exacerbates spike clearing.

c.Ear guessing and deafness worsen.

d.Otorrhea. e.Worsening of systemic symptoms is onset.

Correct answer: d

Perforated tympanic membrane is a serious condition that can affect hearing and cause many other complications. So, what are the causes of tympanic membrane perforation? Next, let me take you to find out.

Causes of perforation of the tympanic membrane.

1.Direct trauma. It is more common in head trauma with temporal bone fracture and tympanic membrane injury.

In addition, picking your ears too hard or being bumped by others can also break your eardrum. Secondly, splashes of metal powder, slag, welding sparks and accidental drops of corrosives, such as strong acids and strong alkalis, will corrode the tympanic membrane and cause perforation.

2.Indirect trauma. It is common when there is a sharp change in atmospheric pressure, such as a rapid descent of an airplane, a cannonball, a shot, a loud noise, and a wave of air that breaks the eardrum.

Usually slapping can also injure the eardrum and cause perforation. The air pressure in the middle ear cavity rises sharply, and the internal and external air pressure imbalance occurs, such as blowing the nose forcefully.

3.Eustachian tube infection. Otitis media, otitis externa and other ear diseases can cause tympanic membrane perforation, and most of the tympanic membrane perforation is caused by otitis media, and otitis media mostly occurs in infancy, because the baby's eustachian tube is short and thick, the tube is also straight, nasal secretions, milk and other easy to flow into or choke into the middle ear through the eustachian tube.

4.Other factors. Bacterial infection during swimming, washing hair or picking ears in daily life spreads to the middle ear through inflammation, causing inflammation of the middle ear and easily causing perforation of the eardrum.

** method of tympanic membrane perforation.

1.Perforation of the tympanic membrane due to acute otitis media.

Adequate antibiotics should be used as soon as possible to control the infection, and penicillin, cephalosporins and other drugs can be selected. Regional**: After cleaning the external auditory canal with 3% hydrogen peroxide, antibiotics can be used to inject ear fluid, and perforations that cannot heal spontaneously after inflammation control can be considered for surgical repair.

: Chronic inflammation of the proximity to the organs.

2.Perforation of the tympanic membrane due to trauma.

Removal of foreign bodies, blood clots, etc., retained in the external auditory canal. Avoid colds and never blow your nose too hard. Irrigation and dispensing of drugs are prohibited in the external auditory canal, and surgical repair may be considered for large or non-healing perforations.

Examination items for tympanic membrane perforation.

1.Perforation of the tympanic membrane due to acute otitis media.

The tympanic membrane is diffusely congested and swollen, normal landmarks are difficult to identify, pus discharge may be seen at the perforation or fluctuating bright spot lighthouse sign, and hearing examination is mostly conductive hearing loss, and a few may show mixed and neural hearing loss.

2.Perforation of the tympanic membrane due to trauma.

The tympanic membrane is often irregularly or fissuredly perforated, with bruising, blood stains, and blood crusts, and cerebrospinal fluid otorrhea should be considered if the bleeding is heavy or accompanied by watery effusion. Hearing tests are conductive or mixed hearing loss.

Tips to protect your eardrum.

1. When encountering a loud noise, open your mouth quickly to open the eustachian tube; or shut up and plug your ears with both hands to keep the air pressure inside and outside the eardrum in balance; Or use cotton balls to protect the ears from bursting the eardrum.

2. Do not use sharp objects to pick up earwax casually, so as not to puncture the external ear canal and eardrum.

Eardrum perforations include old eardrum perforations and fresh eardrum perforations.

Old perforated eardrum, in which the eardrum is not congested or chronically hyperemic, and the perforation margin is smooth and regular.

Fresh eardrum perforation is mostly caused by external force, knocking, air pressure and other factors, the eardrum is mostly acute hyperemia, a little blood can be seen at or near the perforation edge, and the perforated edge is not smooth and regular.

It is inevitable that a perforated tympanic membrane will directly affect hearing and lead to hearing loss, but the perforation of the tympanic membrane itself does not have a great impact on hearing.

The size and location of the tympanic membrane perforation has a different effect on hearing, and the perforation has a greater effect on hearing at the tense part of the tympanic membrane than at the relaxed part. A perforation of the anterior tympanic membrane causes less hearing loss than a perforation of the posterior eardrum. Even if the eardrum is completely missing, you won't be able to hear a single sound.

In this case, the foreign sound waves are no longer conducted through the ossicular chain, but vibrate the membrane-like circular window membrane in reverse, which can also cause the pressure of the lymphatic fluid to change and produce hearing. So here, the round window film plays a big role, which is why some people call the round window film the "second tympanic membrane".

Although the tympanic membrane is perforated, it is not necessary to be deaf after the tympanic membrane is perforated, but after the tympanic membrane perforation, the middle ear loses its protective barrier, and the middle ear is easily inflamed due to the invasion of external germs, and the patient's hearing and health will be more threatened. In order to avoid the occurrence of other serious harms, patients also need to be immediately effective**.

Can a perforated eardrum cause deafness? I believe that through the above introduction to the dangers of tympanic membrane perforation, everyone has already learned something. Although tympanic membrane perforation will not directly cause deafness, if it is left untreated for a long time, it will cause otitis media, etc., and it will also indirectly lead to deafness, so it should be done as soon as possible**.