Tympanic membrane rupture

Revision as of 20:03, 17 August 2015 by Kxl328 (talk | contribs) (Management)

Background

  • Blunt trauma (hand blow to ear, fall, direct hit)
  • Penetrating trauma (Q-tip, matchstick, gunshot wound, welding spark)
  • Direct ear trauma
  • Lightning strike
  • Barotrauma

Clinical Features

Perforated TM
  • Ear pain
  • History of barotrauma or direct ear trauma

Differential Diagnosis

Ear Diagnoses

External

Internal

Inner/vestibular

Diagnosis

  • Typically clinical

Management

  • Isolated small tympanic membrane perforations
    • Antibiotic ear drops for contaminated wounds - ciprofloxacin suspension (more appropriately viscous than solution)
    • Water precautions (keeping water out of the middle ear)
    • Reevaluation
  • In children after TM perforation due to otitis media, PO Abx preferred over topical
  • Significant hearing loss (≥40 dB), vertigo, nystagmus, ataxia, or facial nerve injury
    • Urgent evaluation by ENT

Disposition

  • Outpatient management

See Also

References