Imaging Studies

Radiography and MRI are of no value unless the clinical picture suggests ossicular destruction and/or cholesteatoma. Asymptomatic perforations, especially if hearing is near normal, require no imaging studies.

Other Tests

See the list below:

Most tympanic membrane perforations (TMPs) are diagnosed using routine otoscopy.
Small perforations may require otomicroscopy for identification.
Some hearing screening programs include middle ear impedance testing.
Screening tympanometry may reveal abnormalities consistent with perforation. Confirmation still requires examination.
Always perform audiometry upon initial TMP diagnosis and again before any repair attempt, whether in the office or in the operating room.
- Preoperative and postoperative audiography should always be performed. A major conductive loss not only alerts the surgeon to the possible existence of ossicular lesions, but documentation of a preexisting sensorineural hearing loss may protect the surgeon from later allegations that the surgery caused the hearing loss.
- Audiometry often reveals normal hearing. The presence of mild conductive hearing loss is consistent with perforation, and a conductive component of at least 30 dB indicates possible ossicular discontinuity or a pathologic condition.

Treatment & Management

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Pusz MD, Robitschek J. Traumatic Hearing Loss in the Context of Blast-Related Tympanic Membrane Perforation. Mil Med. 2017 Jan. 182 (1):e1645-e1648. [QxMD MEDLINE Link].
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Media Gallery

Tympanic membrane (TM) as continuation of the upper wall of external auditory canal (EAC) with angle of incline up to 45 degrees on the border between middle ear and the EAC.

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Author

Robert A Saadi, MD Assistant Professor, Fellow in Advanced Otology, Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences

Robert A Saadi, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Huseyin Isildak, MD, AuD Assistant Professor of Surgery, Pennsylvania State University College of Medicine; Director of Otology and Neurotology, Director of Cochlear Implant Program, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Penn State Milton S Hershey Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Gerard J Gianoli, MD Clinical Associate Professor, Departments of Otolaryngology-Head and Neck Surgery and Pediatrics, Tulane University School of Medicine; President, The Ear and Balance Institute; Board of Directors, Ponchartrain Surgery Center

Gerard J Gianoli, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Neurotology Society, American Otological Society, Society of University Otolaryngologists-Head and Neck Surgeons, Triological Society

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan; Ryte; Neosoma; MI10<br/>Received income in an amount equal to or greater than $250 from: Neosoma; Cyberionix (CYBX)<br/>Received ownership interest from Cerescan for consulting for: Neosoma, MI10.

Sections Middle Ear, Tympanic Membrane, Perforations
Overview
Workup
Treatment
Questions & Answers
References

Middle Ear, Tympanic Membrane, Perforations Workup

Imaging Studies

Other Tests

References

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