My eardrum pierced, and now?
Before we talk about perforated eardrum it is important to explain how this process works. The eardrum membrane is a shield that separates the outer ear from the middle ear. The middle ear is an air filled cavity that contains the ossicles of hearing. The sound is picked up by the vibration of the tympanic membrane, which causes the ossicles to move. For everything to work well, the pressure of the air contained within the middle ear should be the same as the atmospheric pressure of the place where we are. The opening of the auditory tube, which connects the middle ear to the deepest part of the nose, connects the middle ear to the external environment.
An interesting fact is that nasal problems such as rhinitis and enlargement of the adenoid on the back of the nose) can clog the auditory tube and impair ear aeration. In situations such as diving or flight, the change in atmospheric pressure can be very abrupt to the point that the middle ear fails to equalize the internal pressure with the external environment at the same time. The tympanic membrane is drawn by external pressure and can be ruptured.
Another condition in which the eardrum can be perforated is infections. In severe cases, the ear is filled with purulent secretion that presses on the eardrum leading to its rupture. Objects that are inserted into the ear with too much force (such as cotton swabs) or substances such as acids and very hot water can also rupture the eardrum.
Treatment and care
In order to treat the perforated eardrum, infection must first be removed (otitis ). Because the eardrum is a protective barrier, its rupture facilitates the entry of bacteria. If the doctor notices signs of infection, treatment will be done with antibiotics, which may be by mouth or otological drops. Pain is usually severe in these cases and, in general, anti-inflammatories and analgesics are needed.
Water protection is the primary care when the eardrum has been perforated. During the medical follow-up, it may be opted for observation, waiting a period of a few months for the drilling to close spontaneously. If it does not, surgery may be needed to repair the eardrum.
To protect against water at the time of bathing, a cotton ball soaked in some oil, such as almond oil, should be placed as a against water.
A change in atmospheric pressure, such as in flights or a rise or fall of a saw, will not cause any changes as drilling acts as a communication with the external environment. The middle ear pressure will be equal to atmospheric pressure.
In certain cases, especially if perforation has occurred due to infection, the eardrum can regenerate. This will depend on a number of factors, such as the extent of the perforation, the delay in treating the infection, and the patient's immunity.
About the risks of the problem recurring, everything will depend on the cause of the perforation. In general, recurrent perforations are related to chronic infections and nasal diseases. Untreated rhinitis or adenoid hypertrophy leads to poor ventilation of the ear. In the case of adenoid, removal may be required with surgery.
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