| Description |
: |
Two months later, the perforation has healed spontaneously.
Note the scab which has been carried superiorly by the migrating epithelium, and can now be seen lying over the anterior process of the malleus.
Damage from violent pressure changes within the external canal may vary from hemorrhagic streaks along the handle of the malleus or over the gars flaccida, to a rupture of the pars tensa and disruption of the ossicular chain. When the tympanic membrane ruptures from this type of injury, the perforation is almost always located in the pars tensa and is most commonly situated in the anteroinferior quadrant. The most frequent cause for this type of injury is a slap on the ear.
Symptoms associated with traumatic perforations include impaired hearing, tinnitus, pain, bleeding from the ear, and the sensation of air escaping from the ear on nose blowing. The perforation may appear as a small linear tear, a single hole with ragged edges or, in severe injuries, multiple punched out holes. Fragments of squamous epithelium may be driven into the middle ear and subsequently may give rise to an implantation cholesteatoma. |
