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Eardrum, ruptured

A condition that can result from an accidental direct blow with a sharp object or by indirect means such as very loud bang or an explosion, or by sudden greatly increased pressure resulting from a slap on the ear. Children can perforate their eardrum by accidentally sticking an object in their ear. The fact that the eardrum has been ruptured is usually apparent from a diminished sense of hearing. It is essential to examine the ear in order to establish whether the auditory ossicles, or even the inner ear itself, is damaged. A small tear in the eardrum generally heals of its own accord. If this does not occur within a few weeks, it may be necessary to close it by means of an operation. Barotrauma is a special form of force applied to the eardrum. It occurs when there are large pressure variations in the surrounding air, such as in an aircraft. The pressure in the middle ear is normally kept equal to that in the surroundings by the Eustachian tube being opened during swallowing and chewing movements. When the tube is closed by a swelling of the mucous membrane caused by a cold in the head, a significant partial vacuum can develop in the middle ear when the pressure increases again as the aircraft descends. This leads to intense earache and a loss of hearing. In rare cases, the eardrum can be perforated when the pressure suddenly increases. A partial vacuum of this kind can be prevented and remedied by ensuring that the Eustachian tube is opening regularly. This can be achieved by swallowing. If there is still a partial vacuum in the ear, a doctor can remedy this by blowing into the nose with a special balloon while the victim at the same moment says a word with a nasal sound. If the tube does not open even then, the eardrum must be pierced. Spontaneous perforation of the eardrum occurs in acute untreated otitis media. This perforation heals of its own accord. If the opening persists, and if there is a constant discharge of pus from the ear, it may be an indication of chronic otitis media.

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