Tympanic Membrane Perforation

Excerpt

Tympanic membrane perforation is when the tympanic membrane (TM) ruptures, creating a hole between the external and middle ear. The TM is a layer of cartilaginous connective tissue, with skin on the outer surface and mucosa covering the inner surface that separates the external auditory canal from the middle ear and ossicles. The TM function is to aid in hearing by creating vibrations whenever struck by sound waves and transmitting those vibrations to the inner ear. When the tympanic membrane perforates, it may no longer create the vibrational patterns, leading to hearing loss in some instances.

Tympanic membrane rupture can occur at any age, although it is mainly seen in the younger population, associated with acute otitis media. As a patient's age increases, trauma becomes a more likely cause of TM rupture. Men are more likely to experience TM perforation compared to women.

Signs and symptoms of tympanic membrane perforation are the same despite the cause of the rupture. There is often sudden onset of pain, followed by relief, with associated otorrhea. Tinnitus and vertiginous symptoms may also be experienced.

Overall, TM perforation has a favorable prognosis with a small risk of complications. Perforations tend to heal spontaneously without intervention. It is important to know when intervention and early referral is required, based on size, location, and symptoms associated with the perforation.