An eardrum rupture, or perforation of the tympanic membrane, often heals on its own but may sometimes require Tympanoplasty surgery.
But it's essential to seek medical attention to address the underlying causes, prevent worsening, and potentially avoid surgery. Without proper care, complications can arise, and an ENT specialist can guide you through treatment to manage or prevent these issues.
What Causes a Perforated Eardrum?
Several factors can cause eardrum perforation, such as:
Blowing your nose
Flying or diving while having an infection in the nose (cold)
Riding fast elevators while having an infection in the nose (cold)
High-speed travel in the mountains while having an infection in the nose (cold)
Fungal or bacterial ear infections
Cleaning ears with objects
Slaps or loud noises
Air pressure changes
Ear infections like Otitis Externa or Otitis Media
Accidents where injury happened to the head
Can a ruptured eardrum heal on its own?
90% of the eardrum ruptures tend to heal on their own within 3 months, the remaining 10% that don’t heal will need a Tympanoplasty surgery.
3-month mark for eardrum rupture
Any eardrum rupture that has been unhealed for 3 months or more is unlikely to heal and will require surgery. Waiting too long can lead to other problems, like Tympanosclerosis and new infections.
Let’s say an ear infection caused the perforation. To avoid Tympanoplasty surgery, the infection needs to be treated as early as possible (it must be controlled or cured within 3 months).
Treatment for a Ruptured Eardrum
The treatment for a ruptured eardrum depends on the severity and cause of the rupture.
Initial Treatment if Required
Address the Infections
The first step is to treat the underlying cause of the rupture, in case the cause is an infection:
It is crucial to treat these infections early. Fungal infections, like otomycosis, are often harder to heal than bacterial infections.
Minor Procedures for Traumatic Eardrum Perforations
Most ruptured eardrums caused by trauma rather than infection tend to heal on their own. However, some cases may require minimally invasive procedures to promote healing. These procedures are performed under a microscope, where the edges of the eardrum are carefully repositioned to their original alignment. A temporary gel is then applied to hold the edges in place, supporting proper healing.
2. Waiting Period – Healing Time
In most cases, 90% of eardrum ruptures heal on their own within three months. Doctors usually monitor the healing process during this time. If it hasn’t healed by then, it’s less likely to heal on its own, and further treatment may be required.
There will be some precautions that you will need to follow during this time to avoid worsening of the condition.
3. Surgery – Tympanoplasty
If the rupture doesn’t heal naturally, a surgical procedure called tympanoplasty may be necessary. This surgery repairs the eardrum by reconstructing it with tissue taken from behind the ear. This tissue helps form a new eardrum, restoring its structure and function.
During tympanoplasty:
A small piece of tissue is taken from behind the ear.
The tissue is used to create a new eardrum, allowing the skin and mucosa to grow over it.
Cost of the Tympanoplasty surgery
The cost of surgery can vary based on the procedure:
The cost of tympanoplasty surgery can range from ₹1,00,000 to ₹2,00,000 (approximately $1,200 to $2,500, these are all-inclusive costs ), depending on the complexity of the case and the hospital.
The cost of the minor procedure ranges from ₹5,000 to ₹10,000 (approximately $60 to $120, these are all-inclusive costs).
Consequences of Untreated Eardrum Rupture
Leaving a perforated eardrum untreated, can lead to serious complications. Here are the potential risks:
Spread of Infection
If an eardrum perforation is not treated, infections can spread from the middle ear to the external ear and vice versa. This can cause permanent damage that might not be treatable medically or surgically.
Tympanosclerosis (Calcium Buildup)
Untreated perforations can cause the lining of the middle ear to dry up, leading to calcium deposits. These deposits can stiffen the bones in the middle ear (malleus, incus, and stapes), which are crucial for hearing. When these bones lose their ability to move, sound transmission is impaired, leading to hearing loss. This condition, called Tympanosclerosis, is difficult to treat, and hearing aids may be the only solution.
Increased Risk of Middle Ear Infection (Otitis Media)
The perforation exposes the middle ear to the external environment, making it vulnerable to bacterial infections. Although airborne infections are rare, contaminated water entering through the ear canal can increase the risk. Even water that doesn’t contain bacteria can carry bacteria from the external ear into the middle ear, worsening the perforation and potentially leading to permanent damage.
Inner Ear Damage
If bacteria or toxins from a middle ear infection reach the inner ear, it can cause nerve deafness. Unfortunately, this type of hearing loss is irreversible and cannot be corrected with medicine or surgery.
Conclusion:
While 90% of eardrum ruptures heal without surgery, timely medical intervention is essential for optimal recovery. For the remaining 10% of cases where healing does not occur, Tympanoplasty can effectively address the issue. However, if a tear persists untreated, it may lead to serious complications, resulting in irreversible damage to the bones or nerves involved in hearing. Therefore, seeking prompt medical attention for eardrum perforations is crucial to prevent long-term consequences.
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