A perforation, which is a rupture or damage to the eardrum, may cause your child to have hearing loss and requires special care to ensure that water does not get in the ear canal. ENT for Children can help if you are concerned that your child has a perforated eardrum.
What Is the Eardrum?
The eardrum is the tissue that separates the ear canal and the middle ear. It vibrates from sound waves striking it, and structures in the middle and inner ears translate these sound waves into nerve impulses.
Additionally, the eardrum also protects the middle ear from water, bacteria and other foreign substances.
What Happens When the Eardrum is Ruptured?
A perforation creates a hole in the tympanic membrane across the eardrum. Because this limits its ability to vibrate, it can result in hearing loss. Additionally, it can allow bacteria to enter the ear and lead to an ear infection.
What Causes a Ruptured Eardrum?
This condition can result from:
- Infection: Pressure from middle ear infections can lead to a ruptured eardrum.
- Injury: This can range from head trauma to inserting foreign objects in the ear.
- Eustachian tube disorders: Chronic Eustachian tube problems can weaken the eardrum, making it more prone to perforation.
What Are the Symptoms of a Perforated Eardrum?
- A sudden sharp pain in the ear
- A discharge of fluid that may be bloody, clear or pus-like
- A buzzing or ringing in the ear
- Partial or complete hearing loss in the affected ear
- Ear infection
- Facial weakness or dizziness
How a Perforated Eardrum Is Treated
Eardrum repair involves surgical procedures in children to correct and repair the perforated eardrum. Some of the commonly used procedures for treating eardrum perforations include:
Myringoplasty/Paper Patch
Myringoplasty (Mer-RING-go-plas-tee) is one option for repairing small holes in the eardrum. A small patch made of special paper is placed on top of the hole. The process usually takes 10-30 minutes to complete and is performed through the ear canal.
Myringoplasty/Fat Patch
This type of Myringoplasty uses a fat patch (a small piece of the child’s fat usually harvested from behind the ear or the back of the neck) instead of paper to seal the hole in the eardrum. The fat patch functions much like a paper patch. The fat graft can be used for small to medium-sized holes in the eardrum and is also performed through the ear canal.
Tympanoplasty
Tympanoplasty (Tim-PAN-oh-plas-tee) is typically performed to repair larger holes in the eardrum. In this procedure, a graft from the patient’s own tissue is used to patch the hole. The entire process takes 2-3 hours. Tympanoplasty is often recommended for larger holes or when previous myringoplasty procedures have failed to close the hole.
Ossicular Chain Reconstruction
A surgical procedure called Ossicular Chain Reconstruction is performed if the ossicles sustain injury. The ossicles are three tiny bones located behind the eardrum that make up the Ossicular Chain. These bones connect the eardrum to the inner ear. This surgery aims to rebuild the ossicular chain and enhance hearing. Often, the reconstruction is done during a “second-look” procedure to confirm there is no remaining cholesteatoma.
Ossicular chain reconstruction can be completed by making an incision behind the ear or through the ear canal to access the ear. If the middle ear bones are damaged, it may be possible to reposition the bones so that your child’s own ossicles are used for the reconstruction. If the ossicles or parts of them are absent, they are replaced with a man-made prosthesis, which is often made from titanium.
A prosthesis can be used to:
- Bridge a gap between damaged ossicles
- Bridge a gap from the ear drum to the residual ossicles (partial ossicular prosthesis)
- Bridge a gap from the ear drum directly to the inner ear (total ossicular prosthesis)
How Can I Prevent a Perforated Eardrum?
- Avoid putting objects in your child’s ears
- Seek treatment for middle ear infections
- Protect your child’s ears from loud noises
When Does My Child Need Treatment?
Call our office if you think your child may have a ruptured eardrum. Though it might heal on its own, our provider can determine what’s causing your child’s symptoms. In some cases, surgery might be required, and our team is here to guide your family through this time.
Call ENT for Children for more information or to schedule an appointment.