Ruptured eardrum
The tympanic membrane is highly sensitive to sudden changes in pressure in the external auditory canal and may get easily affected by these changes and get damaged. These perforations that occur are generally prone to spontaneous closure; however, the perforation size and possibility of spontaneous recovery are negatively correlated, and large perforations need longer recovery time
In this article:
- Treatment
- Patching
- Antibiotics
- Surgery
- What is new in treatment
- Lifestyle and home remedies
- Recovery from eardrum rupture
- References
Treatment
The clinically practical approach to the ruptured tympanic membrane (TM) without infection is mostly conservative. The ear should be protected from infection and that the external auditory canal should be kept clean and dry.
A follow-up duration of three to four weeks following perforation is sufficient for spontaneous cure in cases of small perforations. However, various surgical procedures such as myringoplasty might be necessary in some of the cases, in which perforation closure does not occur at the end of this period.
Patching
Materials such as cigarette paper, fat, gelatin film, and silk can be used in the paper patch procedure, which can be easily performed and does not require hospitalization.
Gelfoam patch plus edge approximation results were analyzed in a recent review. Such treatment only shortened the healing time, but did not improve the healing rate.
Antibiotics
Your doctor may recommend a course of antibiotics in a situation of the ruptured eardrum. While topical antibiotic drops may be recommended, oral antibiotics are not indicated unless there is an ear infection.
Research findings indicate that the moist eardrum environment resulting from topical application of ofloxacin drops shortened the closure time and improved the closure rate, but did not affect hearing improvement or increase the rate of middle ear infection of large traumatic TMPs. Thus, although traumatic TMPs tend to heal spontaneously, moist therapy can be considered for traumatic, large hole TMPs in the clinic.
Surgery
Tympanoplasty is the surgical procedure performed to repair a perforated TM, with or without reconstruction of the ossicles (ossiculoplasty), with the aim of preventing reinfection and restoring hearing ability. Chronic suppurative otitis media is the most common indication; large invasive cholesteatomas may require a mastoidectomy as well as reconstruction of the TM.
In clinical practice, most traumatic tympanic membrane perforations (TMPs) tend to heal spontaneously. However, large perforations often fail to do so. A majority of otolaryngologists suggest that early myringoplasty should be performed to improve the healing rate, Nevertheless, this procedure requires general anaesthesia and expensive equipment, resulting in a patients’ high cost.
In addition, most large traumatic TMPs have curled edges, and the necessity to manipulate curled edges is also controversial. Some authors believe that curled edges may result in abnormal epithelium migration and failure of closure; in particular, inverted edges could migrate into the tympanum and develop middle ear cholesteatoma; ideal management should be to restore the original position.
What is new in treatment
Basic fibroblast growth factor (bFGF). This is a biological molecule produced by the body that is known to facilitate in skin healing. Topical application of bFGF, which can be simply carried out by patients themselves at home, is able to improve the closure rate and shorten the closure time without significant adverse effects. As a result, bFGF drops may be considered as an ideal management option for large traumatic TMPs.
Lifestyle and home remedies
It is important to talk about ear health with your children and warn them not to put anything inside the ear canal. For adults it is equally important to understand the value of the protective ear plugs and headphones while at work.
Loud sounds can be very harmful to the eardrum and hearing apparatus. Talk to your teenage kids about the music volume in the headphones, and prank jokes with loud sound.
There is no need for home remedies if the eardrum ruptured. If the tear is small it will heal on its own. It is actually best not to put anything in the ear canal. You can facilitate recovery by taking supplements boosting healing and immune system, such as vit C, reishi mushroom, Echinacea, probiotics and fish oil. There is some evidence that using colloidal silver in the ear canal prevents a possibility of infection, but make sure you talk to a Natural Doctor first.
Recovery from eardrum rupture
Recovery from the eardrum trauma depends on many factors:
- The size of rupture
- The location of the tear
- The presence of infection
- The extent of trauma to the skull
- Overall health
No one can predict for sure how long will it take for the eardrum to heal. Also, it is not possible to predict if the hearing will return to normal. The follow up with ENT specialist and frequent hearing tests will show your own recovery rate and predict if it will be complete.
References
Determinants of spontaneous healing in traumatic perforations of the tympanic membrane. Orji FT, Agu CC.Clin Otolaryngol. 2008 Oct;33(5):420-6. doi: 10.1111/j.1749-4486.2008.01764.x.PMID: 18983374
A moist edge environment aids the regeneration of traumatic tympanic membrane perforations. Lou ZC, Lou ZH.J Laryngol Otol. 2017 Jul;131(7):564-571. doi: 10.1017/S0022215117001001. Epub 2017 May 15.PMID: 28502255 Review.
Tympanoplasty. Brar S, Watters C, Winters R.2021 Jun 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–.PMID: 33351422 Free Books & Documents. Review.
Healing outcomes of large (>50%) traumatic membrane perforations with inverted edges following no intervention, edge approximation and fibroblast growth factor application; a sequential allocation, three-armed trial. Lou ZC, Wang YB.Clin Otolaryngol. 2013 Aug;38(4):289-96. doi: 10.1111/coa.12135.PMID: 23731690 Free PMC article. Clinical Trial.
Lou Z, Lou Z, Tang Y, Xiao J. The effect of ofloxacin otic drops on the regeneration of human traumatic tympanic membrane perforations. Clin Otolaryngol. 2016 Oct;41(5):564-70. [PubMed]
Albera R, Ferrero V, Lacilla M, Canale A. Tympanic reperforation in myringoplasty: evaluation of prognostic factors. Ann Otol Rhinol Laryngol. 2006 Dec;115(12):875-9. [PubMed]