scholarly journals Clinical Presentation and Conservative Management of Tympanic Membrane Perforation during Intrapartum Valsalva Maneuver

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Jonathan D. Baum ◽  
Meghan I. Rattigan ◽  
Eric Scott Sills ◽  
Anthony P. H. Walsh
Keyword(s):  
Tympanic Membrane ◽  
Vaginal Delivery ◽  
Valsalva Maneuver ◽  
Tympanic Membrane Perforation ◽  
Normal Vaginal Delivery ◽  
Intraabdominal Pressure ◽  
Ear Canal ◽  
Membrane Rupture ◽  
Active Labor ◽  
Membrane Perforation

Background.Tympanic membrane perforation may occur when ear pressures are excessive, including valsalva maneuver associated with active labor and vaginal delivery. A pressure differential across the eardrum of about 5 psi can cause rupture; the increased intraabdominal pressure spikes repeatedly manifested by “pushing” during second-stage labor easily approach (and may exceed) this level.Material and Method.We describe a healthy 21-year old nulliparous patient admitted in active labor at 39-weeks' gestational age.Results.Blood appeared asymptomatically in the left ear canal at delivery during active, closed-glottis pushing. Otoscopic examination confirmed perforation of the left tympanic membrane. Complete resolution of the eardrum rupture was noted at postpartum check-up six weeks later.Conclusion.While the precise incidence of intrapartum tympanic membrane rupture is not known, it may be unrecognized without gross blood in the ear canal or subjective hearing loss following delivery. Only one prior published report on tympanic membrane perforation during delivery currently appears in the medical literature; this is the first English language description of the event. Since a vigorous and repetitive valsalva effort is common in normal vaginal delivery, clinicians should be aware of the potential for otic complications associated with the increased intraabdominal pressure characteristic of this technique.

Potential ototoxicity from triamcinolone, neomycin, gramicidin and nystatin (Tri-Adcortyl™) cream

2005 ◽  
Vol 119 (1) ◽  
pp. 48-50 ◽  
Author(s):  
S P Thomas ◽  
J R Buckland ◽  
S R Rhys-Williams
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Sensorineural Hearing ◽  
Ear Canal ◽  
Membrane Perforation ◽  
Perforated Tympanic Membrane

Although rare, ototoxicity from the use of aminoglycoside drops is well recognized. Ototoxicity has not been described with the use of combination aminoglycoside-steroid-antifungal creams or ointments. We present the case of a 60-year-old man with a perforated tympanic membrane who suffered a total hearing loss after the instillation of cream containing triamcinolone, neomycin, gramicidin and nystatin (Tri-Adcortyl™ cream) into his ear canal. On balance, we believe that a number of potentially ototoxic constituents in this cream were responsible. Other possible causes of sensorineural hearing loss and the possible mechanisms of ototoxicity of this cream are discussed. The reasons why such creams may be particularly ototoxic, compared with drops, are also considered. The authors caution against the use of such creams or ointments in the ear if there is any suspicion of a tympanic membrane perforation.

Equivalent Ear Canal Volumes in Children Pre- and Post-Tympanostomy Tube Insertion

1992 ◽  
Vol 35 (4) ◽  
pp. 936-941 ◽  
Author(s):  
Janet E. Shanks ◽  
Patricia G. Stelmachowicz ◽  
Kathryn L. Beauchaine ◽  
Laura Schulte
Keyword(s):  
Tympanic Membrane ◽  
Error Rate ◽  
Tympanic Membrane Perforation ◽  
Tympanostomy Tube ◽  
Ear Canal ◽  
Tube Insertion ◽  
Absolute Value ◽  
Membrane Perforation ◽  
The Absolute

Pre- and postoperative equivalent ear canal volume measures were obtained from a group of 334 children ranging in age from 6 weeks to 6.7 years. The purpose of the study was to develop volumetric guidelines for the determination of tympanostomy tube patency. For children 4 years and older, almost no ambiguity existed in making this determination accurately. For younger children, the pre- and postoperative distributions overlap. A criterion value of ≥1.0 cm 3 as an indicator of a tympanic membrane perforation appears to yield the lowest possible error rate. When both pre- and postoperative measures are available, a difference of ≥0.4 cm 3 can be used in conjunction with the absolute value to identify a patent tympanostomy tube.

scholarly journals Tympanic membrane perforation, otitis media and labyrinthitis caused by otomycosis confirmed by intravenous gadolinium 1.5 tesla MRI-a case report

2021 ◽  
Vol 11 (1) ◽  
pp. 1-3
Author(s):  
Chunhui Yang
Keyword(s):  
Case Report ◽  
Inner Ear ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Fungal Infections ◽  
Tympanic Membrane Perforation ◽  
Asian Woman ◽  
Ear Canal ◽  
Membrane Perforation ◽  
Cerumen Removal

Otomycosis is a fungal ear infection, mostly a superficial mycotic infection of the outer ear canal. The infection may be either subacute or acute but chronic form is around 10%. The characteristic of otomycosis are discharge, pruritus, or more severe discomfort. Here we report a 46-year-old Asian woman presented with vertigo and was diagnosed as otomycosis with the complications of tympanic membrane perforation, otitis media and labyrinthitis of inner ear which was confirmed by IV-Gd 1.5 T MRI. This case is a chronic otomycosis related to cerumen removal two year before this onset. Our study supported the suggestion that otomycosis should include fungal infections of the middle and inner ear, furthermore the infection of the inner ear may be included as labyrinthitis with the symptom of vertigo.

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