Torn eardrum
definition
The eardrum is a flat, thin membrane that separates the outer ear from the middle ear. It seals these two structures completely from one another. If the continuity of the eardrum is broken, it is called a torn eardrum. When inspecting the eardrum, the doctor visually sees a hole in this structure.
causes
The cause of a torn eardrum is always one Overuse its elasticity. It does not matter whether it is a cotton swab that is pressed too hard against the eardrum when cleaning the ear canal, or a blow to the ear that triggers a strong pressure wave towards the middle ear. Is the one on the eardrum acting force too great, it cannot be deflected any further in one direction and tears.
When flying it is the increasing air pressure in the cabin during landing that creates a suction effect in the middle ear. In a diving accident it is the too rapidly decreasing ambient pressure on ascent that leads to an increase in volume in the middle ear. Everyone too much pressurewhich cannot be compensated in time leads to the fact that the paper-thin membrane ruptures due to the tension.
Self a Effusion in the middle ear can rupture due to the weight of the pent-up fluid. The crack itself can be seen as relief in the case of an effusion. Any excessive pressure from the middle ear could destroy structures in the middle ear and thus affect hearing. A hole in the eardrum allows compensation and thus protection of the ossicles.
The tearing through one too much external pressure, serves as a buffer. The air or the foreign body should not pass the ear structures unhindered and possibly manipulate the anchoring of the auditory ossicles. The eardrum therefore catches the coarsest and serves as a warning function, since tearing it causes severe pain. At this point, at the latest, the person affected should notice that they should turn their head or remove a foreign body.
diagnosis
The diagnosis of a torn eardrum is made by its optical observation posed. But the doctor looks with you Ear specula into the outer ear canal to the eardrum and looks at its structure. If a crack or hole can be seen, the surrounding structures can provide clues as to the cause. A strong secretion and Redness would for one Otitis media speak with effusion and bleeding or trauma marks. The anamnesis of course also enables the cause to be clarified. In divers, for example, an ear mirror often confirms the suspected diagnosis of a torn eardrum.
Symptoms
The symptoms of a torn eardrum are very specific and easy to identify yourself. Initial Does it hurtwhen the eardrum ruptures. Affected people feel you sharp short earachewhich appears unusually violent. This is usually followed by a sudden hearing loss which can vary in strength depending on the size of the crack. The hearing loss lasts for a certain period of time and does not change in intensity on the first day. It only decreases as the eardrum heals and disappears completely when the patient has recovered completely.
At inflammatory cracks can a secretion be noticed from the ear that is either clear, purulent, or bloody. The secretion is from an otitis media, which relieves her effusion through the outer ear. In the context of inflammation can additionally fever or even just one increased body temperature occur.
A Dizziness Finally, it is also possible that the Irritation of the inner ear justified. However, vertigo is only specific to a torn eardrum if it is present with at least one other symptom already mentioned. Dizziness alone is more likely to indicate other causes.
Treatment / therapy
A torn eardrum usually becomes conservative treated. So there is no manipulation of the eardrum or attempt to cover the defect. The background to this often wait and see attitude is that the eardrum can regenerate itself very well with small cracks. Only in the case of cracks with frayed edges or very large cracks is one Splint the defect with silicone film necessary. If this method is not sufficient, the defect must be covered with the body's own material, which is known as Myringoplasty referred to as.
Medication only found at severe pain or one otitis media caused by bacteria their commitment. Especially for bacterial infections, the prescription of Antibiotics useful to inhibit the growth of bacteria and thus support wound healing. So that bacteria do not even get into the middle ear through a perforated eardrum, the ear is important dry and clean to keep. Sufferers must therefore seal their external ear canal with cotton and avoid water getting into the ear. Even when showering, cotton wool and careful handling of the shower head should protect the affected ear from water ingress. The moisture would be a perfect breeding ground for bacteria and would only delay wound healing.
Operation for a tear in the eardrum
One surgery only comes In rare cases for the treatment of a torn eardrum. If the eardrum does not heal by itself due to a defect that is too large, or if it tears excessively, surgical treatment is a promising therapeutic option. The operation is doing as sooner minor surgery to see the average below one hour takes and with one local anesthesia or in general anesthetic can be carried out.
From a cosmetic point of view, only a small incision behind the ear is necessary, which leaves an inconspicuous small scar. The aim of the procedure is to reconstruct the eardrum. You use it as a material body's own structures like the fascia of the temporal muscle or a tight layer of connective tissue from the auricle. The advantage of the body's own material is that it is from the body is not repelledwhen it is implanted in the ear as the eardrum. Also is the removed material very elastic and nevertheless tightso that it works properly.
During the procedure, the functionality of the Ossicular chain assessed and, if necessary, repaired damage. Depending on the degree of impairment of the ossicles, the operation is carried out in four types assigned. Depending on the type, the surgeon corrects more or less parts of the auditory ossicles and anchors them with the new eardrum. Relatively little pain is to be expected after the operation. For the patients it is more like that Packing uncomfortable in the affected ear, impairing hearing. However, it is essential for wound healing and must remain in the ear canal for about three weeks. After all, the success rate for a successful closure of the eardrum is included 95%.
Duration of a tear in the eardrum
The time it takes for an eardrum to heal completely is only one a few days. The symptoms caused by the crack may last longer, but should be up to two weeks do not exceed. Should be a massive otitis media be the cause of the tear, the healing can be approx one week last. Any crack that persists for a long time indicates improper healing and should further receive medical attention. Only one Hearing loss due to a torn eardrum, up to two months exist and is due to the changed ability to vibrate due to the new tissue.
Torn eardrum in the child
In relation to adults, children suffer from otitis media quite often and therefore have a increased risk also develop a torn eardrum. The main reason for the increased susceptibility to infection is that frequent contact with the pathogen. In kindergarten in particular, the immune system of a child is confronted with many pathogens that his immune system is not yet aware of. Transmission is easy when playing games and the infection develops after an incubation period.
From an anatomical point of view, the body and in this case especially the throat area of the child favors the development of an infection in the middle ear area. The Eustachian tube, which connects the throat to the middle ear, is in children Growth process. It changes from a short tube that is almost horizontal to the row of teeth to a longer tube that is more vertical. As long as the inclined position of the Eustachian tube is not reached, the physiological cleaning process is not fully developed.
The force of gravity cannot be used optimally if the angle to the drainage of secretion and pathogens is not steep enough to the throat. For pathogens this means a easy ascent towards the middle ear. The mucous membrane swells reactively in the throat and in the Eustachian tube and the middle ear is sealed off. A humid chamber An optimal environment for the bacteria now forms in the middle ear. Your growth favors you Inflammatory responsewhich leads to the formation of pus and secretion until the secretion builds up so massively that the pressure on the eardrum becomes too great. Since the secretion cannot drain through the swollen Eustachian tube, it tears the eardrum.
The Relief of the middle ear makes sense physiologically. Parents can notice the tearing by giving an indication of ear pain from the child and later the leakage of secretions or pus from the ear. Usually the pain subsides as the secretion begins to flow. Even so, a doctor should examine the ear to assess the damage to the eardrum and, if possible, initiate therapy.
Torn eardrum in the baby
It's not uncommon for babies to have torn eardrums. Straight in the winter months they catch cold quickly and the infection leads to swelling of the mucous membranes in the throat area and thus also in the Eustachian tube. The Eustachian tube is a connection between the middle ear and the throat in all people and serves that Pressure equalization of the middle ear.
It is with babies especially short and lies almost horizontalso that pathogens can easily reach the middle ear as part of a cold. There they find an optimal breeding ground, as the swollen mucous membranes seal the middle ear to the throat moist environment create. The multiplication of bacteria and the associated Inflammatory response triggers a strong secretion of the mucous membranes Pus formation out. If the accumulated fluid volume is too large and exerts too much pressure on the eardrum, it empties through the external auditory canal through a rupture of the eardrum.
For the baby, both the otitis media and the tear in the eardrum are one painful process. Constant whimpering and hand movements towards the ear can indicate a torn eardrum. If secretion escapes from the ear, this is almost conclusive. But also high fever with constant restlessness can on a Otitis media Clues. Stopping drinking suggests painful sucking and swallowing. One reason for this pain can be insufficient pressure equalization be between the throat and the middle ear during swallowing, which can be caused by the swollen mucous membranes.
If there is any suspicion of a torn eardrum, a Pediatrician must be visited in order to save the baby unnecessary pain and not to reduce his desire to drink. Most of the time, a torn eardrum can also be seen as harmless. However, if it is not assessed by a doctor, a large defect can be overlooked, which in the worst case affects the development of hearing.
Can you fly with a torn eardrum?
There is nothing wrong with flying with a torn eardrum.
The pressure equalization during take-off and landing can easily be done with a tear in the eardrum. In fact, pressure equalization is even easier for the ear, as the air can move freely between the outer ear and the middle ear without the eardrum having to be deflected under tension. One should only be aware that traveling by air is often associated with vacation. Water or pathogens can easily get through the torn eardrum and trigger an otitis media. This requires the person affected to absolutely avoid water sports and to protect the middle ear from dust and pathogens.
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