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Perforated Tympanic Membrane

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • The tympanic membrane (TM), or “ear drum,” is a thin, trilaminar barrier that separates the external auditory canal (EAC) from the middle ear. Along with the ossicles of the middle e...

DIAGNOSIS

HISTORY

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

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

  • Tinnitus or buzzing

  • Self-audible whistling from the ear ...

TREATMENT

GENERAL MEASURES

  • Most TM perforations are nonurgent and do not require immediate evaluation by an otolaryngologist. Often, these can be managed with drops and pain control to decrease inflamm...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

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

  • It is vital to reexamine the ear, especially after an episode of infec...

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]
2
Naylor JF. Otoscope fogging:...

ADDITIONAL READING

  • Jensen RG, Koch A, Homøe P. Long-term tympanic membrane pathology dynamics and spontaneous healing in chronic suppurative otitis media. Pediatr Infect Dis J.  2012;31(2):139–14...

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 ...

CLINICAL PEARLS

  • To evaluate a patient with a suspected TM perforation, history and physical exam will usually suffice and does not require imaging.

  • Most TM perforations do not require immediate evaluat...

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