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Conditions We Treat

Ear Conditions & Treatments

Learn more about eardrum perforation, cholesteatoma, and mastoiditis.

female ent doctor and patient in office ear exam

What is Eardrum Perforation?

An eardrum perforation is defined as a hole or rupture in the eardrum. Known medically as a tympanic membrane rupture, this tear occurs in the membrane separating your outer ear from your inner ear. A perforation can lead to a middle ear infection and possible hearing loss, though in many cases it will heal on its own without medical treatment.

The eardrum converts sound waves into nerve impulses that are sent to the brain, and it protects the middle ear from bacteria, moisture, and other foreign objects. A perforation can disrupt both important functions, allowing bacteria to enter the ear and cause an ear infection (otitis media) or contribute to a loss of hearing.

African American Woman with ear pain

What Can Cause Eardrum Perforations?

Eardrum perforations are most often caused by infection, injury or eustachian tube disorders. Middle ear infections cause a buildup of pressure that may result in a ruptured eardrum.

Injury or trauma to the ear or head can cause a perforation, as can a skull fracture or sudden loud noise, such as an explosion.

Inserting objects like bobby pins or cotton swabs in the ear to clean wax can inadvertently cause a rupture as well. Chronic eustachian tube problems can weaken the eardrum, making it more prone to perforation.

What Are the Symptoms of Eardrum Perforation?

Some people are completely unaware of a ruptured eardrum; there may be a complete lack of symptoms or only a feeling of general discomfort. Other times, people will experience symptoms such as:

  • a sudden sharp pain in the ear
  • discharge of fluid that may be
  • bloody, clear, or pus-like
  • buzzing or ringing in the ear
  • partial or complete hearing loss in the affected ear
  • ear infection
  • facial weakness
  • dizziness

How Are Eardrum Perforations Treated?

A member of our highly-qualified ENT doctor team will examine your ears with an otoscope to visually identify a hole or tear in the eardrum. Because the majority of perforated eardrums heal on their own in a few months, no treatment may be needed other than antibiotics to prevent or treat infection.

Nonprescription pain medication and a warm compress can help. Large perforations may require surgery. While the rupture is healing, you’ll need to keep the ear dry, avoiding water as much as possible.

What is Cholesteatoma?

Cholesteatoma is an abnormal skin growth in the middle ear behind the eardrum that may also affect the mastoid (skull bone). It begins as a cyst that can gradually increase in size, destroying the bones of the middle ear and causing hearing loss.

What Causes Cholesteatoma?

When the eustachian tube is functioning normally, it equalizes ear pressure by moving air from the back of the nose into the middle ear. Allergies and viruses can affect performance, leading to a partial vacuum in the ear.

This negative pressure stretches the eardrum, creating a pocket or cyst that fills with old skin cells and waste material, which can become easily infected. In rare cases, cholesteatoma can be congenital (present at birth).

What Are the Symptoms of Cholesteatoma?

Symptoms of cholesteatoma include drainage from the ear, a feeling of fullness, hearing loss, earache and dizziness. Since these are also present in other conditions, tests such as CT scans and electronystagmography can be used to rule out other conditions and confirm the diagnosis. Cholesteatomas continue to grow if not treated and can lead to complications including the following:

  • Deafness
  • Facial paralysis
  • Brain abscess
  • Meningitis.

How Is Cholesteatoma Treated?

One of our highly-qualified ENT doctors will determine the size and growth rate of the cholesteatoma and recommend treatment based on these findings. Controlling the infection with antibiotics or eardrops is a crucial first step.

If you have a cholesteatoma, it may be treated surgically. Performed under general anesthesia on an outpatient basis, the cholesteatoma is removed in order to eliminate the infection. Follow-up surgery to ensure the cholesteatoma is gone and to reconstruct damaged middle ear bones may be necessary.

What is Mastoid Surgery?

Mastoid surgery (mastoidectomy) involves the removal of diseased mastoid air cells. These air cells are located in the hollow spaces within your mastoid bone, which is located just behind your ear. The surgery is often performed to treat infections of the middle ear or to improve hearing.

Mastoiditis Causes & Symptoms

The medical term for infection of the mastoid cells is mastoiditis. The condition affects children more often than adults since they are most prone to middle ear infections, but can affect adults on occasion. Bacteria migrate from the middle ear to the air cells of the mastoid bone, which are essential for proper drainage of fluid. Cholesteatoma, a type of skin cyst, can also prevent the ear from draining properly leading to mastoiditis.

Symptoms of mastoiditis include swelling, redness, and tenderness of the ear lobe and area behind the ear as well as drainage of fluids from the ear, fever, irritability, and lethargy.

How is Mastoiditis Diagnosed and Treated?

Mastoiditis can cause serious—even life-threatening—health complications if untreated, so proper diagnosis is a crucial first step toward recovery. Our doctors will examine your ears with an otoscope, looking for signs of infection. Diagnostic tests such as a CT scan or MRI may be administered to help rule out other conditions.

Many cases of mastoiditis are treated successfully with antibiotics. Chronic cases may require frequent visits for thorough ear cleanings. When antibiotics fail to treat the problem adequately, or it recurs frequently, surgery may be necessary.

physician examining ear of cheerful kid

What to Expect with a Mastoidectomy

Mastoid surgery, or mastoidectomy, involves drilling a hole in the mastoid bone and removing the infected air cells. This procedure is performed under general anesthesia, and many patients return home later the same day.

Afterwards, your ears will be bandaged, and there may be stitches. You might experience headaches, discomfort, and numbness. You’ll likely be prescribed pain medication and antibiotics and will need to return after a few days to have your bandages and stitches removed. You’ll need to keep your ear free of water, and avoid strenuous activity or anything that might create pressure in your ear (e.g. airplane travel).

Complications are rare, but might include facial nerve paralysis, sensorineural hearing loss, vertigo, tinnitus, and a change in taste.

Call Texas ENT & Allergy at (877) 377-4368 for more information or to schedule an appointment.

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