The eardrum is located between the outer ear and the middle ear. Its outer surface is balanced by atmospheric pressure, while its inner surface by the air coming from the throat through the Eustachian tube. The eardrum transmits sound from the outer ear to the middle ear by vibrating and has important functions such as preventing foreign substances from entering the middle ear. It may be perforated for different reasons.
There are many factors that cause tympanic membrane perforation. The question “What causes tympanic membrane perforation?” can be answered as follows:
Except for all these reasons, falling on the ear, an explosion near the person, exposure to shock waves, hot fluids escaping into the ear canals and scuba diving may also cause the tympanic membrane perforation.
When the eardrum is perforated, dirty water may enter the middle ear and bacteria may form in the region; infection may also occur as a result of foreign substances reaching the middle ear. People with tympanic membrane perforation may experience hearing loss depending on the size of the perforation, its location on the tympanic membrane and the presence of different pathologies in the ear. In addition, the tympanic membrane perforation may also damage bone structures that play an important role in hearing, such as anvil, stirrup and hammer; these bone structures may break due to trauma or melt due to infection. In such a case, the operation becomes essential.
I cannot make a sweeping statement that the tympanic membrane perforation, which manifests itself with symptoms such as tinnitus, dizziness, ear discharge and sharp ear pain, will always be treated surgically. I can say that the eardrum heals with traditional treatments without the need for an operation in some patients. However, if the eardrum cannot heal by itself, it has been damaged to a large extent, otitis media occurs due to damage to the eardrum, there is an inflammatory tissue (cholesteatoma) that progresses by melting the bone inside the mastoid bone, the eardrum repair surgery become inevitable.
Eardrum repair can be done with different techniques depending on the extent of damage to the eardrum and whether there are additional problems in the ear.
When the perforation in the eardrum is small, myringoplasty technique can be preferred for eardrum surgery. This technique, which allows the eardrum to be repaired with a small graft, is replaced by tympanoplasty when it comes to inflammation of the ear and hearing loss. Tympanoplasty provides to repair the damage of the auditory system in the middle ear due to inflammation, purify the mastoid bone from inflammation and also repair the eardrum.