Perforation of tympanic membrane Intruduction n n Tympanic

Perforation of tympanic membrane

Intruduction n n Tympanic membrane also called Eardrum. It receives sound vibrations from the outer air & Transmits them to the auditory ossicles.

Definition n Ear drum rapture is an a one of the clinical condition in which tear or whole present in the ear drum characterized by the hearing impaired.

n Direct force Etiology Careless while removal of wax n Foreign bodies n Skull fracture may tear TM n Slap on ear n Sneezing, Nose blowing, lifting heavy objects n

n Indirect force n Increase in violence and fire-arms n Associated with loud noise n More likely to involve intracranial lesions n Middle ear infections n Barotrauma n Rapid pressure fluctuations with the inner ear n Air travel or SCUBA diving

complications n n Ossicular discontinuity Facial Nerve Injury tympanic Nerve Injury Conducting Hearing Loss

Clinic presentations n n n n Otalgia Bleeding Fullness Hearing loss: conductive HL or mixed HL Tinnitus Vertigo Disorientation

Physical examination n Tympanic perforation n Central perforation n Marginal perforation Blood crust n If skull base fracture is occurred with CSF leakage, clear fluid is observed. n

Diagnosis Otoscope n Tympanogram n trauma to ossicular chain or to inner ear. n The audiometry can provide useful information's. n n CHL n inner ear injury

Managements n n n n Antibiotic to prevent infection Aseptic external auditory canal with alcohol Prevent super respiratory infection Prohibit nasal blow Prohibit ear drops It takes 3 -4 w to heal the ear drum If 3 months later, perforation still exists, myringoplasty is indicated.

n n Surgical Mgt Tympanoplasty (Grafting) Myringoplasty (Repair) Ossiculoplasty

Nursing diagnosis n n n Pain related to inflammation and pressure on tympanic membrane. Risk for infection related to istachian tube dysfunction. Impaired verbal communication related to ear drum rapture. Imbalance nutrition less than body requirement related less in take. Fear & anxiety related to progression of disease.

Preventions n n n Be caution while removing your wax Using ear plug Taking air and holding the breath while jumping Or pinching nose Avoid flies