The tympanic membrane is the ear drum. Look inside the ear tube. If there is no wax or swelling, you will see it. Normally it is a grey-ish color .
A ruptured ear drum(also known as perforated) is one with a hole in it.
Quickcare or ER
Red Flags that will send you to the ER:
- Severe pain
- Severe swelling
For the most part, ear infections even with a tympanic membrane perforation, can be seen in a Quickcare Clinic.
What will your doctor ask?
Your doctor will want to know your ruptured ear drum symptoms. A SYMPTOM is your description of your condition to your doctor. It is your story.
Answers to the following questions will help your doctor understand.
Is it only in your ear or does it go to the jaw and arm?
How bad is the pain?
Does the pain come and go or is it constant?
Did you see any fluid/pus drain out?
Were you exposed to a blast or trauma?
Were you using cotton swabs?
What will your doctor look for?
Just to go through a little anatomy….The ear canal is simply a tube. At the end of this tube is a drum leading to the middle ear. Connecting the middle ear to the sinus area is the eustachian tube.
During the examination, a doctor will use the otoscope and look into the canal. Usually within a few seconds, a determination of the problem is made. A complaint of ear pain may be an inflamed ear canal (Otitis Externa). Another possibility is an ear drum can be swollen and red without a hole in it. This is otitis media.
In my experience, the hole is visible and usually there is fluid flowing.
What is your doctor thinking?
Your doctor will create a mental list of possible reasons for your signs and symptoms. This list is called a differential diagnosis.
As an ER doctor, I always think of the worse things first. In this case, an elderly man with left ear pain has to trigger a thought that this may be a heart problem.
Ear canal infection (otitis externa) will require antibiotic drops.
Ear drum infections (otitis media)need antibiotic pills.
Is it possible for the infection to spread deep into the boney area of the skull (Mastoiditis)? Yes. But it is very rare and I have never seen it.
What is the treatment of?
If I see a hole in the ear drum, I give both antibiotic pills such as Augmentin and antibiotic ear drops such as Cortisporin otic suspension. For pain, I prescribe non-steroidal anti-inflammatory medications such as Naproxen.
If the popped ear drum was a result of a trauma or blast, I hold off on any antibiotics.
Then, I refer to an Ear, Nose and Throat doctor, who is a specialist. A detailed look at the inner ear bones is warranted. Should these three small bones (malleus, incus and stapes) be damaged, a considered treatment would be ossicular reconstruction.
How long will you be sick?
A regular infection takes about a week to heal. If the ear drum is open, then additional 2-3 weeks are needed. Long term effects may include hearing loss. Again, an Ear, Nose and Throat specialist should be involved.
Let me tell you a story
Little Skinny Julio looked way older than his stated 50 years old. The sun ages you. It causes wrinkles. Without sunscreen protection, skin takes a beating. After 30 years of picking chiles in the San Jauquin Valley, his face looked like a prune.
His hands were so dark and palms thick as leather.
His work puts the vegetables on the plates American families. After decades, he had no education. No money. No documents. Just a bad back from all his labor. He is the type of guy that a humane doctor (like me) naturally wants to help.
So, he says,” Doctor, my ear hurts” I had just seen him 3 days ago. Julio was ok. This was an isolated ear pain. He had an infection and was treated with an antibiotic. Hmmm. Did this mean that the antibiotic was not strong enough?
In the case of Little Skinny Julio, his pain was local to his ear, sharp, constant, severe. Associated with the pain was a discharge that kept oozing out. Julio had an extra problem. The drum had a hole in it and pus had oozed out.
Little Julio took his pills and used the drops. The specialist merely reexamined him after two weeks and Julio was back picking our nation’s vegetables.
I hope this helps.