Eardrum Holes

If the infection in the middle ear cavity continues for more than 3 months, it is called chronic otitis media.

Chronic ear infections and perforation of the eardrum are generally examined in 3 main sections.

dry ears with a hole in the eardrum

runny ears with a hole in the eardrum

ears with cholesteatoma

DRY EARS WITH HOLES IN THE EARDrum

In these patients, the infection in the middle ear subsided. There is no active inflammatory process in the middle ear. However, as a sequelae of the infection, the eardrum remained perforated. This hole may be very small, or the entire eardrum may be completely lost. These ears are always at risk of recurrence of infection. When there is an infection, a discharge begins in the ear. In these patients, there is a hearing loss of around 20-40 dB due to the perforation of the eardrum. If there is damage to the ossicles in the middle ear, hearing loss may be greater. Perforations of the eardrum in early rotation may heal spontaneously and close. However, as the duration increases, the chance of closing decreases, and if the duration exceeds 3 months, there is no chance of spontaneous closing. In such a case, the eardrum needs to be repaired with a surgery called tympanoplasty.

 

DRAINED EARS WITH HOLES IN THE EARDrum

In these patients, the eardrum is perforated and there is an active inflammatory process in the middle ear. As a result, there is usually a foul-smelling discharge in the ear. The patient has conductive hearing loss of 30-60 dB. In these patients, the chance of damage to the ossicular system is higher than in dry ears.

In these patients, it is primarily aimed to cure the infection with drug therapy. For this purpose, in addition to the use of oral antibiotics, antibiotic and cortisone drops are applied to the ear. If the infection is removed with drug treatment and the ear is made dry, then the hole in the eardrum is repaired with tympanoplasty. However, if the ear discharge does not stop despite drug treatment, surgical treatment should be applied in these patients. Because chronic infection in the middle ear can cause serious problems such as melting of the ossicles, meningitis, brain abscess and permanent hearing loss. In these patients, the middle ear infection is cleared and the eardrum is repaired with a method called tympanomastoidectomy.

 

EAR WITH CHOLESTETOMA

The term cholesteatoma is briefly defined as the skin in the wrong place, where it should not be. Normally, the middle ear cavity is covered by a covering we call the mucous membrane. In some cases, this cover is replaced by skin tissue and a disease called cholesteatoma occurs. The cholesteatoma tissue grows by folding over itself, just like an onion. It causes the surrounding bone tissue to melt and rot with its pressure effect and some substances it secretes. As the cholesteatoma in the middle ear cavity grows, it first causes the ossicles to melt and then the ear bone to melt. After a while, it may reach the outside of the ear bone and cause very serious complications such as facial paralysis, abscess formation under the skin, meningitis, brain abscess formation, and destruction of the inner ear.

The diagnosis of cholesteatoma is made by visualization of cholesteatoma tissue during ear examination and radiological examinations. There is no drug treatment for cholesteatoma. The only procedure to be done is surgical removal of the entire cholesteatoma.

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