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Perforated Tympanic Membrane

Jordan I. Teitelbaum, FARS, DO Reviewed 04/2024
 


BASICS

DESCRIPTION

  • The tympanic membrane (TM), or “eardrum,” is a thin and mobile three-layered barrier that separates the external auditory canal (EAC) from the middle ear space and hearing bones (oss...

DIAGNOSIS

HISTORY

  • Otorrhea/ear drainage (pus, blood, or clear fluid)

  • Otalgia or earache consistent with AOM (perhaps associated with sudden relief)

  • Tinnitus or buzzing (ipsilateral)

  • Self-audible whistling...

TREATMENT

GENERAL MEASURES

  • Most perforations are non-urgent and do not require immediate evaluation by an otolaryngologist (ENT). Often, they can be managed with ototopical drops and pain control to de...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Follow-up should be done to confirm TM healing and to obtain an audiogram with tympanometry.

  • Reexamine the ear, especially after an episode of in...

REFERENCES

1
Rye  MS, Blackwell  JM, Jamieson  SE. Genetic susceptibility to otitis media in childhood. Laryngoscope.  2012;122(3):665–675. [View Abstract on OvidMedline] ...

CODES

ICD10

  • H72.90 Unsp perforation of tympanic membrane, unspecified ear

  • H72.00 Central perforation of tympanic membrane, unspecified ear

  • H72.2X9 Other marginal perforations of tympanic membrane, unsp e...

CLINICAL PEARLS

  • To evaluate a patient with a suspected TM perforation, history and physical exam are important. Audiogram will ultimately be indicated for nonhealing perforations, and imaging may be i...

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