The eardrum can be injured and damaged, thereby developing
perforation of the tympanic membrane
. This phenomenon can also occur due to physical, chemical, thermal factors. If damaged there is pain, congestion in the ear, noise is all lowers hearing acuity. Directly the clinical picture depends on the degree of influencing of lesions and the strength of the traumatic factor.
The tympanic membrane consists of several layers the outer (ear canal, which is a continuation of the epidermis), middle (radial and circular fibrous fibres), internal (mucosa in the tympanic cavity). This membrane is located in the ear canal and is protective, i.e. prevents the ingress of foreign bodies, air, water, and various microorganisms. The tympanic membrane also performs the function of zvukoprovodnost it transmitted the vibrations to a sound apparatus.
Depending on the nature of the damage, especially when you break the eardrum, perhaps, its total destruction. Rupture of the tympanic membrane disrupts its separate layers or elements of a membrane.
Anyway, but her injuries carry extra risk in the form of various infectious negative factors (mastoiditis, chronic purulent middle
, labyrinthitis, atomikos, etc.).
Damage to the eardrum can develop due to various reasons. In particular, due to the mechanical damage resulting from ear trauma, use of items not intended for cleaning the ear, the incorrect extraction of cerumen, foreign body in the ear, and also damage due to traumatic brain injury.
Physical factors causing damage to the membrane are the pressure drop in the area of the tympanic cavity and external auditory canal, strike the ear. The eardrum can be damaged by acoustic as a result of jumping from a height, strong sneezing with a closed nose, falling on the ear, testing in the chamber, the conduct of diving operations. The barotrauma to the eardrum can be accompanied by aerosinusitis, aeration and cause damage to the vessel in the membrane, disrupt the individual layers or elements of a membrane.
Damage of the eardrum is characterized by a thermal burn of the ear. Such damage can occur because of industrial or home accidents (with pottery or smithing). Chemical damage occurs by contact with the auditory passages of aggressive chemicals, which in turn could destroy the eardrum.
The defeat of the tympanic membrane may also occur due to wounds from shrapnel or bullets during military operations.
Symptoms of damage to the eardrum usually accompanied by sharp pain around the ear, which may eventually subside, but in the future, there are complaints of congestion and noise in the ear and reduced acuity of hearing. Symptoms of ruptured eardrum is characterized by the fact that when blowing your nose or sneezing celebrates the release of air from the ear. Using the Valsalva test is noted the same result, but it is desirable to conduct, since it is possible to get an infection.
The clinical picture of symptoms depends on the extent of damage to the eardrum. Minor damage is not noticed hearing loss, since broken only the outer layer of individual fibers. If extensive damage is seen, the dislocation or rupture of the joints, fracture of the ossicles, injury of the muscles in the cavity of the ear. When fractured, there is an intense noise and hearing loss mixed, vestibular disorders, leakage of perilymph from the ear.
Signs of damage of the tympanic membrane in most cases (about 90%) accompanied by trauma to the ear, which in turn can diagnose the trauma. Of course, for skilled and optimal diagnosis requires examination and consultation of the doctor-otolaryngologist.
When unusual symptoms of perforation of the eardrum is possible to conduct an endoscopic examination, which is based on microeconomy and otoscopy.
To evaluate the auditory and the vestibular apparatus by using the stabilography, calorics, audiometry, acoustic impedance, threshold eometrie, vestibulometry, electrocochleography, research of tuning fork.
If the damage of the eardrum takes place a secondary infection, it is necessary to conduct a bacteriological examination of the fluid emitted from the ear.
Treatment of perforation of the tympanic membrane with simple forms is conducted without much interference. In the case of an extraneous body in the ear is carried out to delete, and in the presence of blood clots wipe them with a dry swab of cotton wool, treat the ear canal with ethyl alcohol.
If there is a danger of development of complications of an inflammatory nature, given oral antibiotics. And when secondary infection the treatment is carried out on the principle of treatment of otitis media. In some cases, the treatment of rupture of the tympanic membrane requires surgical intervention. For this purpose, myringoplasty and tympanoplasty, when the eardrum has a hole. To close the perforations used fascia of the temporal muscle, chicken amnion, meatotympanal flap and so on.
Recently modern methods of treatment is supplemented with a new developed method of closing perforations with transplantatsii cultivated allofibroblasts. But it is usually used if the hole is not shivsena and hit more than 50 percent of its area.