Tympanic membrane rupture: Difference between revisions

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==Management==
==Management==
===Isolated, Small Perforation===
===Isolated, Small Perforation===
**Antibiotic ear drops for contaminated wounds - [[ciprofloxacin]] suspension (more appropriately viscous than solution)
**Antibiotic ear drops for contaminated wounds - [[Ofloxacin]] is safe for perforation
**Don't give [[Ciprofloxacin]] can damage the inner ear
**Water precautions (keeping water out of the middle ear), avoid forceful Valsalva
**Water precautions (keeping water out of the middle ear), avoid forceful Valsalva
**Reevaluation with PCM, typical healing within 4-6 weeks
**Reevaluation with PCM, typical healing within 4-6 weeks

Revision as of 17:44, 17 August 2021

Background

Ear anatomy

Causes

Clinical Features

Smaller perforation
Larger perforation (acute)
Larger perforation (chronic)

Differential Diagnosis

Ear Diagnoses

External

Internal

Inner/vestibular

Evaluation

  • Typically clinical

Diagnosis

Definition of "complicated or large perforation" (see management):

Management

Isolated, Small Perforation

    • Antibiotic ear drops for contaminated wounds - Ofloxacin is safe for perforation
    • Don't give Ciprofloxacin can damage the inner ear
    • Water precautions (keeping water out of the middle ear), avoid forceful Valsalva
    • Reevaluation with PCM, typical healing within 4-6 weeks

Isolated, Small Perforation (Pediatric)

Complicated or Large Perforation

See Diagnosis section for definition

  • As for simple perforations (see above), plus:
    • Urgent evaluation by ENT

Disposition

  • Outpatient management
    • Complicated or larger perforations require expedited ENT follow up

See Also

References