A ruptured, or perforated, eardrum is a tear in the thin membrane that separates the inner ear from the middle ear. The eardrum is an important part of how we hear, as it is instrumental in the process of converting a sound wave that enters the ear into an electrical signal that gets sent to the brain. The eardrum also works as a barrier to keep water and other objects from entering the middle ear.
Ear infections are the most common cause of a ruptured eardrum. An infection in the middle ear creates pressure; this pressure pushes against the eardrum. If the pressure gets too great, the eardrum can tear. Pressure changes, such as what occurs when a plane changes altitude quickly, can also cause a tear. Foreign objects inserted into the ear, head injury or acoustic trauma resulting from an extremely loud noise have been known to cause tears to the eardrum as well.
The symptoms experienced by those with a ruptured eardrum can vary. The most common symptoms are a sudden sharp pain, drainage from the ear, buzzing or hearing loss. Some may not feel anything at all.
If you experience any of these symptoms, contact your doctor as soon as possible. To confirm the diagnosis, your doctor will use an otoscope, a device with a light on the end, to look inside your ear. Usually, the hole or tear is visible. In order to test if the ruptured eardrum has affected your hearing, your doctor will also perform some hearing tests.
The treatment for a tear in the eardrum is minimal; usually the eardrum will heal on its own within three months. To prevent ear infections, you may be prescribed antibiotic drops. To prevent pain, over-the-counter pain medication can be taken. If the eardrum is slow to heal or the perforation is too large, surgery may be needed. Your doctor will use a piece of your own tissue to mend the tear in a simple, outpatient procedure.
An acoustic neuroma is a benign tumor of the cranial nerve that connects the inner ear and the brain. Though noncancerous and typically slow growing, it can affect both hearing and balance, and may cause hearing loss, tinnitus and dizziness. In rare cases, tumors may become large enough to press against the brain, interfering with vital processes and even leading to death.
A small percentage of acoustic neuromas are the result of an inherited disorder called neurofibromatosis type II (NF2), associated with a malfunctioning gene on chromosome 22. This genetic disorder often causes benign tumors to develop on the balance nerves on both sides of the head. More often than not, acoustic neuromas are classified as sporadic, meaning their exact cause is unknown. There is some evidence of a connection between exposure to low-dose radiation of the head and neck during childhood and the development of acoustic neuromas.
There are no known risk factors for acoustic neuromas other than having a parent with NF2. If this is the case, children have a 50% chance of inheriting the condition themselves.
Acoustic neuromas, sometimes called vestibular schwannomas, usually grow very slowly (or not at all). Because of this, symptoms early on are often difficult to spot. You may notice gradual hearing loss that is sometimes accompanied by tinnitus. If the tumor continues to grow, additional symptoms are likely to develop. These include dizziness and vertigo, facial numbness and weakness, a tingling sensation in the face, changes in taste, hoarseness, difficulty swallowing, headaches and confusion. Early diagnosis and treatment can help prevent more serious symptoms.
Your otolaryngologist can diagnose an acoustic neuroma primarily through a review of your symptoms in conjunction with a hearing test and imaging scans (CT or MRI). Because growth of the tumor is usually very slow, many times your doctor will simply want to monitor the tumor’s progress over time, especially when few symptoms are present. Regular imaging tests every six to 12 months can track any growth.
Surgery may be an option for tumors that are growing or causing symptoms. Gamma Knife radiosurgery delivers radiation without the need for an incision, but results can take a long time. More invasive surgery may be required, especially if your tumor is growing close to the brain or facial nerve.
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