Traumatic tympanic membrane rupture| symptoms, differential diagnosis and treatment

Causes of tympanic membrane rupture

  • Self induced as during cleaning.
  • During ear wash.
  • Slap on the ear.
  • Otitic baro trauma.
  • Blast injuries; compression and rarefaction waves.

Symptoms and signs of traumatic tympanic membrane rupture:

  • Deafness.
  • Otalgia (pain in the ear).
  • Bleeding per ear (does not clot if mixed with CSF).
  • T.M perforation (see the table).
  • Blood clots in external auditory canal EAC.
  • Tuning fork: Conductive deafness.

Differential diagnosis of  traumatic from pathological perforation of tympanic membrane

Treatment of Traumatic tympanic membrane rupture

a- Conservative
- Keep ear sterile, no water entry or ear drops
- Systemic antibiotics, nasal decongestants & avoid nose blowing.
- In most cases it heals spontaneously.
b- Surgical
Myringoplasty in persistent perforation (after 6 months).

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