Perforated Ear Drum

[bestmum]

MY 12 nearly 13 yrs old daughter has had problems with her from being little. She has suffered numerous ear infections over the years. She also had 2 sets of grommets in. She had been suffering with sore ears again since the summer. Went to see G.P. he referred her to E.N.T. specialist at local hospital. She went to see them about 6 wks ago and said she had a small perforation, but this morning before she went to school she was complaining. Managed to get an appt. with our G.P. she examined her ear and said that she had no eardrum left. She said she will fax E.N.T.department for emergency appt. Does anyone know what they will do to try and repair the eardrum. Sorry its such a long question but wanted to tell the full story. Hope someone can shed some light on this as daughter is very worried about what might happe. many thanks bestmum

[Sqad]

If it is a straight forward perforation then an operation can be performed.......fascial graft to repair the eardrum....Myringoplasty if it is just the eardrum that needs repairing or Tympanoplasty if the drum and ossicles need repairing................this is no big deal.

However if the perforation is associated with what is known as a cholesteatoma, which I suspect from you account then a more extensive operation, modified radical mastoidectomy is required..........this is a bigger deal.

Only an ENT Consultant will be able to tell you which type of perforation your daughter has.

If the discharge is offensive and smells of rotten cheese, then it is suspicious of a cholesteotoma.

Cholesteotoma is not a tumour, but an ingrowth of skin into the middle ear which erodes bone.

[bestmum]

Dear Sqad Thank you very much for you quick and detailed answer. If she has any of the operations how long is she likely to be in hospital. She is nearly 13 and when her ear weeps it smells disgusting, She has taken all the precautions when showering or washing her ear and she hasn't been swimming. We were hoping it might have healed over by itself but obviously its getting bigger. Is there anything we can do to help her with this problem? Thanks once again sqad.

[Sqad]

If she has a myringoplasty, then she will be in hospital for one day only.

If she has a cholesteatoma , then she will need the more radical procedure and she will be in hospital for 3or 4 days.

best....from what you say, I would put my month's pay on this being a cholesteatoma.........I hope she proves me wrong.

P.S Which is your nearest ENT Unit?

[bestmum]

Dear Sqad our nearest ent department is in Arrowe Park Hospital, Wirral, Merseyside. It is a good hospital I have just had a total hip replacement in there, but not in the ent dept. I hope she proves you wrong as she will not be happy to have to stay in hospital for 3/4 days. We will cross that bridge when we come to it. I think the hospital were hoping it would close over naturally but its got bigger instead is this normal? Thanks again sqad your advice is invaluable. bestmum

[Sqad]

Excellent Unit.......try to get your GP to see Mr. V.R. Srinivasan..

If there is cholesteatoma, it will NEVER heal.

[bestmum]

Mr. V.R. Srinivasan.. is her specialist anyway. When you say it will never heal what are the ramifications of this. Will she continue to suffer ear infections or will her hearing just get steadily worse.If it will never go is it worthwhile her having the trauma and upset of an op. Your opinion will be very welcome.
again Sqad thanks you are easing my mind a little.bestmum

[Sqad]

If there is a cholesteatoma, then an operation is essential and the object of the operation is to remove it completely, the preservation of hearing purely secondary. She will need to have regular checkups for the rest of her life.......monthly, 6 monthly and then annually.
Surgery for cholesteatoma is complex to explain and depends upon the damage the cholesteatoma has already done and if there is any scope to reconstruct the damaged ossicles.

That is the worst case scenario......let's hope that it is a simple perforation in which a fascial graft operation will be all that is necessary.

Get back to me anytime.