Perforated Tympanic Membrane: (Ruptured Eardrum)

Presentation

The patient experiences ear pain after barotrauma, such as a blow or slap on the ear, an exploding firecracker, a fall while water skiing or during a deep-water dive, or after direct trauma inflicted with a sharp object, such as an open paper clip, cerumen curette, or sharp plant part. Hemorrhage is often noticed within the external canal, and the patient will experience the acute onset of pain (which tends to subside quickly) and some partial hearing loss. Tinnitus or transient vertigo may also be present. Otoscopic examination reveals a defect in the tympanic membrane (TM) that may or may not be accompanied by disruption of the ossicles ( Fig. 38.1 ). The presence of blood may make assessment difficult.