ear, nose, and throat disorders
Traumatic Perforation of the Tympanic Membrane
Diagnosis of Traumatic TM Perforation
Otoscopy Audiometry Perforation is usually evident during otoscopy. Any blood obscuring the ear canal is carefully suctioned at low pressures. Irrigation and pneumatic otoscopy are avoided. Extremely small perforations may require otomicroscopy or middle ear impedance studies for definitive diagnosis (eg, if perforations do not close). If possible, audiometric studies are done before and after treatment to avoid confusion between trauma-induced and treatment-induced hearing loss. Patients with marked Hearing Loss or severe 