Tympanic Membrane Perforation
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Basics
Description
Perforations can be classified in several ways:- Duration:
- Acute (<3 mo)
- Chronic (>3 mo)
- Site:
- Pars tensa
- Pars flaccida
- Extent:
- Limited to 1 quadrant (<25%)
- 2 or more quadrants
- Total perforation
Etiology
- Infection (acute otitis media):
- Most common cause of an acute perforation
- Blunt trauma (slap to the ear):
- Domestic violence, street fight
- Penetrating trauma (Q-tip)
- Extrusion of tympanostomy tubes
- Rapid pressure change (diving, flying):
- Rupture usually occurs between 100 and 400 mm Hg (at a depth of 2.6 ft, there is a pressure differential of 60 mm Hg)
- Extreme noise (blast)
- Lightning
- Acute necrotic myringitis (β-hemolytic streptococcus)
- Slag burns (welding or metalworking)
- Complications of surgical procedures:
- Myringotomy, tympanoplasty, tympanostomy tube insertion
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Basics
Description
Perforations can be classified in several ways:- Duration:
- Acute (<3 mo)
- Chronic (>3 mo)
- Site:
- Pars tensa
- Pars flaccida
- Extent:
- Limited to 1 quadrant (<25%)
- 2 or more quadrants
- Total perforation
Etiology
- Infection (acute otitis media):
- Most common cause of an acute perforation
- Blunt trauma (slap to the ear):
- Domestic violence, street fight
- Penetrating trauma (Q-tip)
- Extrusion of tympanostomy tubes
- Rapid pressure change (diving, flying):
- Rupture usually occurs between 100 and 400 mm Hg (at a depth of 2.6 ft, there is a pressure differential of 60 mm Hg)
- Extreme noise (blast)
- Lightning
- Acute necrotic myringitis (β-hemolytic streptococcus)
- Slag burns (welding or metalworking)
- Complications of surgical procedures:
- Myringotomy, tympanoplasty, tympanostomy tube insertion
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