Etiology
1. Trauma
  1. Physical abuse red flag
  2. Foreign body
  3. Forceful Ear Irrigation
2. Infection
  1. Otitis Media
  2. Acute Chronic Otitis Media
3. Middle Ear Barotrauma (e.g. Scuba Injury)
Symptoms
1. Otorrhea
Signs
1. Size perforation as percent of membrane
2. Traumatic perforations often lack discharge
3. Weber lateralizes to side of perforation
Management
1. Keep ear dry
2. Refer to audiologist
3. Drop use is controversial
  1. Cortisporin Otic Suspension 1 drop qid
  2. Ciprofloxacin Ophthalmic (Ciloxan) 1 drop qid
4. Surgery for large perforations
Prognosis
1. Usually heal well spontaneously in 4-6 weeks
2. Large or marginal perforations may require surgery

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/16/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.