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perforated tympanic membrane (perforated eardrum)

Etiology: - trauma - blast injury Pathology: - a large perforation prevents the tympanic membrane from vibrating normally [2] - conductive hearing loss Differential diagnosis: - rule out cholesteoma Complications: - sudden hearing loss after a blast injury accompanied by vertigo with nystagmus suggests possible fistula to the inner ear [3] Management: - for otitis externa in patients with perforated eardrum, use Ciprodex or ofloxacin otic; these are sterile, Cipro HC is not - ENT consult for surgery

Related

tympanic membrane (eardrum)

General

ear disease perforation

References

  1. Prescriber's Letter 16(8): 2009 COMMENTARY: Drug Treatments for Swimmer's Ear: An Update GUIDELINES: Acute Otits Externa Detail-Document#: 250821 (subscription needed) http://www.prescribersletter.com
  2. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
  3. van Rijswijk JB, Dubach P Binaural Tympanic-Membrane Perforations after Blast Injury. N Engl J Med 2017; 376:e41. May 11, 2017 PMID: 28490003 Free Article http://www.nejm.org/doi/full/10.1056/NEJMicm1612629