Diseases of the eardrum
Due to its small thickness and its sensitive structure, the eardrum is quite susceptible to injuries. Hard objects can cause direct trauma (perforation). Indirect injuries in the form of ruptures of the eardrum (rupture) can occur as a result of blows to the ear or nearby explosions (so-called barotrauma).
In this case, stabbing pain in the ear, hearing loss and possible bleeding are usually the first symptoms of damage to the eardrum. Since the protective barrier between the outer and middle ear is also damaged in this case, pathogens can enter the tympanic cavity (especially through water penetration), which can lead to inflammation of the middle ear (otitis media). In general, however, perforations of the eardrum show a good tendency to heal spontaneously.If healing takes place without complications, a period of about 4 weeks is assumed until the ruptured eardrum is completely closed.
Complicated ruptures can be splinted with a foil by the ear, nose and throat specialist. If the ossicles have been injured, however, permanent hearing loss may occur. In any case, an ENT physician should be consulted at an early stage.
If spontaneous healing is not possible, the defect can be closed by a tympanoplasty. This is a surgical procedure which serves to restore the ossicular chain and the eardrum. For this purpose, the body’s own tissue is usually used, usually muscle skin (fascia) or cartilage skin of the tragus or auricle.
If it is necessary to replace the ossicles, prostheses made of materials such as ceramic or titanium can be used.
- Tympanic membrane injuries
- Tympanoplasty
One of the most common diseases of the eardrum is perforation of the eardrum, also known as a torn eardrum or “hole in the eardrum”. There are several causes for the development of a perforation.
Firstly, violent external influences can lead to a tear. These include fractures at the base of the skull and direct blows to the ear. Similar injury patterns result in injuries caused by explosions or other sudden pressure effects.
For example, uncontrolled, rapid surfacing during dives is a sudden application of pressure. Cotton swabs inserted too deeply can also cause a hole in the eardrum, so their use is not recommended by a doctor. However, influences from the inside can also cause the eardrum to tear.
For example, if an effusion forms in the middle ear as part of an inflammation of the middle ear, the pressure on the eardrum can increase so much that it tears. In general, the probability of a perforation, regardless of the cause, is always higher if the eardrum is already weakened by inflammatory processes. Contrary to expectations, a perforation of the eardrum is not always noticed immediately.
Hearing loss can occur, but it is often weak. It manifests itself in the feeling that sounds are only muffled and perceived as if from afar. Short-term, stabbing pain may occur.
However, the extent of the pain depends strongly on the cause. For example, if a blow to the ear has caused other injuries besides the rupture of the eardrum, such as a laceration, the pain is naturally much more pronounced. Under certain circumstances, minor bleeding may occur.
The occurrence of dizziness is also possible, since the ear is responsible for the sense of balance in addition to hearing. Dizziness in turn triggers nausea and vomiting. In summary, the symptoms are usually unspecific and rarely allow conclusions to be drawn about the exact cause.
For this reason, an ear, nose and throat doctor should always be consulted if such symptoms occur or a ruptured eardrum is suspected. Only a look into the ear with an otoscope can provide accurate information. Only in rare cases are hearing tests performed in addition to the otoscopy.
The therapy depends on the extent and cause of the perforation. Smaller perforations usually heal by themselves and should only be protected from water, dirt and infections during the healing process. If it is a massive perforation where the edges of the tear are not in contact or the eardrum is already scarred by previous injuries, surgery may be necessary.
In this case, the hole is either sewn back together directly or an additional material is inserted to close the eardrum like a patch. This patch is either a piece of tissue artificially produced from silicone or the body’s own tissue. Since an open eardrum no longer provides protection against infections in the middle ear, antibiotics are always prescribed prophylactically.
If pain is present, a painkiller is prescribed. In addition, it is recommended to shower with caution and not to go swimming during this time. Exactly how long a perforation of the eardrum needs to heal cannot be definitively determined.
The duration depends strongly on the cause and the associated therapy. Simple perforations, which can heal spontaneously, take about one week. If, on the other hand, surgery is required, such a condition can last for several weeks.Your eardrum is ruptured and you don’t know what to do?
An inflammation of the eardrum, also called myringitis, is a possibly extremely painful disease of the eardrum. It is often caused by an inflammation of the middle ear that spreads to the eardrum. In general, the classic symptoms of an inflammation then occur: pain, redness, overheating and loss of function.
The pain is usually already present as a result of the inflammation of the middle ear and can become worse in the worst case. If a doctor looks into the ear, he will be able to detect a reddening of the auditory canal and the eardrum. Normally, the light from the otoscope, which is used to examine the ears, is reflected by the eardrum.
If there is an inflammation, this light reflex is cancelled and the doctor sees a dull, reddened membrane. Overheating can be limited to the ear and the auricle or it can spread systemically throughout the body. If it does so, it is called fever.
Fever occurs frequently in children with eardrum inflammation, but less frequently in adults. Therefore, eardrum inflammation should always be considered if a child develops a fever and the cause is not yet known. The loss of function manifests itself in a hearing loss.
The diagnosis can be made by a doctor who looks into the ear with an otoscope and asks for the patient’s medical history. This is because an inflammation of the middle ear, which spreads to the eardrum, is often caused by a viral cold. Normally, the middle ear is connected to the throat by a duct.
This passage ensures that the middle ear is ventilated and that bacteria that have entered the middle ear can be transported out again. If this passage is blocked due to a cold, bacteria can accumulate in the ear and cause an inflammation. Therefore, previous colds should always be reported to the treating physician to speed up the diagnosis.
A second, but rarer cause is an external infection. Here, the bacteria reach the eardrum through the auditory canal. However, this only happens when the natural protective mechanisms of the auditory canal, small hairs and earwax, are no longer present.
For this reason, the canal should not be cleaned with cotton swabs and earplugs should be worn when swimming frequently. You would like to do without cotton swabs and still safely remove earwax? An eardrum inflammation does not need to be treated with medication, because it usually heals on its own after a few days to a week.
However, if severe pain occurs, painkillers such as ibuprofen or paracetamol can be taken. Ibuprofen is also anti-inflammatory, while paracetamol reduces fever. Depending on the individual constellation of symptoms can therefore be chosen.
In addition, the affected ear should be protected, e.g. from water, and a certain amount of rest may be necessary. If it is a particularly persistent bacterial inflammation, the use of antibiotics may be considered. A doctor should be consulted for this.
As a rule, there are no late effects, but in particularly severe cases there may be long-term hearing loss. Eardrum inflammation does not need to be treated with medication, as it usually heals on its own after a few days to a week. However, if severe pain occurs, painkillers such as ibuprofen or paracetamol can be taken.
Ibuprofen is also anti-inflammatory, while paracetamol reduces fever. Depending on the individual constellation of symptoms can therefore be chosen. In addition, the affected ear should be protected, e.g. from water, and a certain amount of rest may be necessary.
If it is a particularly persistent bacterial inflammation, the use of antibiotics may be considered. A doctor should be consulted for this. As a rule, there are no late effects, but in particularly severe cases there may be long-term hearing loss.
