What causes tympanic membrane perforation (TMP)?

Updated: Dec 14, 2020
  • Author: Robert A Saadi, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Tympanic membrane perforations (TMPs) can result from infection (acute or chronic) or trauma, or be secondary to otologic procedures (iatrogenic). Perforations can be temporary or chronic, and their effect varies with size, location on the drum surface, and the associated pathologic condition. Most TMPs are diagnosed using routine otoscopy. Medical therapy for perforations is directed at controlling otorrhea.

Infection is one of the principal causes of TMPs. Acute otitis media may cause rupture of the drum and generally resolves following control of the infection. [1] Chronic otitis media with perforation may be associated with a chronic draining ear or cholesteatoma. [2] Traumatic perforations occur from blows to the ear, severe atmospheric overpressure, exposure to excessive water pressure (eg, in scuba divers), and improper attempts at wax removal or ear cleaning. Trauma from cotton swabs is a relatively common cause of perforation. Traumatic perforations often resolve spontaneously, particularly when associated with swab use. [3]

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