Otolaryngology Book

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Tympanic Membrane Perforation

Aka: Tympanic Membrane Perforation, Tympanic Membrane Rupture, TM Perforation, TM Rupture
  1. 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)
  2. Symptoms
    1. Otorrhea
  3. Signs
    1. Size perforation as percent of membrane
    2. Traumatic perforations often lack discharge
    3. Weber lateralizes to side of perforation
  4. 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
  5. Prognosis
    1. Usually heal well spontaneously in 4-6 weeks
    2. Large or marginal perforations may require surgery

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