Trauma is a common cause of an eardrum perforation. It is important to note if the patient is dizzy. If dizziness is present, then the inner ear may be damaged and middle ear exploration for a inner ear to middle ear fistula should be considered. An audiogram should also be obtained, since this will help determine it there is damage to the inner ear and middle ear bones. If due to a water injury, i.e. falling during water skiing, the risk of infection is high and antibiotic ear drops should be used.
Treatment usually consists of a ten day course of antibiotics.
After the acute infection, serous ear fluid may persist for weeks. This patient did not respond to antibiotics and was placed on antiviral agents. The photo to the right shows a large mass behind the ear drum which can be seen pulsating with the heart beats.