The physician diagnoses bullous myringitis based on observation of the infection. An analgesic also may be prescribed to alleviate pain. If the eustachian tube is blocked completely, air in the middle ear is gradually reabsorbed and a vacuum will form, pulling the eardrum inward, causing pain and interfering with hearing. This condition is called a retracted eardrum. Sometimes the eustachian tube becomes blocked, but rather than a vacuum being formed, fluid accumulates, causing pain.
Treatment is identical in either case.
The blockage may be due to several conditions, but most commonly it stems from nasal congestion occurring with an upper respiratory infection or respiratory allergy. The physician can observe a retracted eardrum using a lighted examining device. If this is not successful, the physician may make a little slit in the eardrum, a procedure known as a myringotomy. This allows air in, the vacuum disappears, and often the condition rights itself. However, if there is underlying chronic disease in the adenoids, the problem in the eardrum may also become chronic.