Patient's question:
Otitis media with effusion, the doctor said it has perforated. The first episode lasted for about ten days. After it healed on its own, it flared up again due to a fever. Previous treatment and outcomes: The condition improved after medication, but it flared up again with a fever. The assistance provided: Otitis media with effusion can...Doctor's answer:
The baby's eardrum has a strong regenerative ability. Under normal circumstances, after a tympanic membrane perforation, it can heal within 10 to 15 days. However, if there are influencing factors such as chronic inflammation, whether the perforation can heal depends on the specific situation.(1) Acute purulent otitis media
After an acute purulent otitis media perforates the eardrum, purulent discharge may occur in the middle ear. If treated properly—cleaning the discharge with hydrogen peroxide, applying antibiotic drops to the ear, and using systemic antibiotics—the perforation generally heals within 10 to 15 days.
(3) Chronic purulent otitis media
In chronic purulent otitis media, the perforation is usually small and intermittent, with purulent discharge. If the ear remains dry for an extended period, the eardrum may heal on its own. However, if the chronic otitis media perforates a larger area and there is purulent accumulation in the middle ear, the perforation rarely heals. Some patients may even have a persistent perforation with chronic discharge for years.
Therefore, regardless of the cause of the tympanic membrane perforation, proper treatment and care after the perforation usually allow it to heal. The eardrum needs to be rebuilt. If it is not properly rebuilt, you may develop conductive hearing loss. Never let water enter the ear, and avoid spicy or irritating foods.
Precautions:
Most middle ear infection patients experience some degree of hearing loss. In children, prolonged hearing impairment can interfere with their learning interest and ability. In adults, it can affect their social interactions and quality of life. Therefore, patience is essential when dealing with these patients, and the volume may need to be increased for effective communication.
Middle ear infection patients should maintain a calm environment and avoid excessive physical activity. They should not play the flute or blow balloons, and should wash their faces regularly to keep their mouths clean. Breathing through the nose as much as possible is recommended. When napping on their side, the affected ear should face downward. When blowing their noses, they should avoid excessive force. Proper movement also helps keep the nasal passage and eustachian tube open, maintaining metabolic and ventilation functions in the middle ear.
If a fever recurs, especially with nasal congestion, it should not be taken lightly. Early treatment is necessary to prevent the worsening of middle ear infection. For chronic middle ear infection patients with a perforated eardrum, it is particularly important to prevent dirty water from entering the middle ear through the external auditory canal (e.g., when washing hair or skating). In such cases, earplugs may be used to prevent infection. If water enters the ear, a hairdryer can be used to dry it, or the head can be tilted to allow the water to drain. Avoid digging in the ear to prevent further injury.