Tympanic perforation

Question 1

Tympanic perforation presentation

Answer 1

Sudden conductive hearing loss, tinnitus, aching or pain in ear, discharge from ear

Question 2

Tympanic perforation causes

Answer 2

Infection, trauma, pressure changes, sudden loud noises, foreign body

Question 3

Tympanic perforation differentials

Answer 3

Acute otitis media, otitis media with effusion, traumatic otorrhoea, Ramsey hunt syndrome

Question 4

Tympanic perforation investigations

Answer 4

Perforation on otoscopy

Question 5

Tympanic perforation management

Answer 5

Resolve without treatment after a few weeks - don’t go swimming or put anything in your ear, don’t blow nose too hard
Pain relief e.g. paracetamol or ibuprofen
If caused by bacterial infection - antibiotics
If big hole or doesn’t resolve, refer for repair