Perforation of tympanic membrane 耳鼻咽喉科学教材.pptVIP

Perforation of tympanic membrane Chunfu Dai Otolaryngology Department Eye Ear Nose Throat Hospital Fudan University Pathogensis Direct force Careless while removal wax by himself or herself Skull fracture may tear TM Hot slag fly into the ear Pathogenesis Indirect force Increase in violence and firearms Associated with more dismal outcome More likely to involve intracranial lesions Barotrauma Rapid pressure fluctuations with the inner ear Air travel or SCUBA diving “the bends” Associated complications Is usually associated with TM or inner ear trauma unless Iatrogenic Ossicular discontinuity Facial Nerve Injury Chorda tympani Nerve Injury Barotrauma to Stapes footplate Clinic presentations Otalgia Bleeding Fullness Hearing loss: conductive HL or mixed HL Tinnitus Shape of perforation is split Managements Antibiotic to prevent infection Aseptic external auditory canal with alcohol Prevent super respiratory infection Prohibit nasal blow Prohibit ear drops It takes 3-4 w to heal the ear drum If 3 months later, perforation still exists, myringoplasty is indicated. Preventions Be caution while removing your wax Using ear plug