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Difficulty breathing,air through ears.Perforated eardrum?

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ENT Specialist
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My son got punched in the face and now feels like air comes out of his ear when he blows his nose. Is this a punctured eardrum and if so is there anything that can be done for it?
Posted Sat, 21 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

1. The Eustachian tube connects the middle ear (behind the ear drum) to the nose. This tube helps equalize the air pressure on both sides of the eardrum.

2. A slap or sharp blow to the ear often leads to a traumatic ear peroration in the posterio-superior quadrant of the tympanic membrane (eardrum). Rarely, a punch to the nose / face may result in a similar injury. This traumatic perforation has jagged edges and minimal blood / clots. [ As opposed to this a chronic long standing eardrum perforation will have smooth round edges. Sometimes such perforations may be discovered on examination where a patient of assault has pre-existing ear perforation.]

3. When a perforation is present in the eardrum, blowing the nose causes rapid airflow with air being forced out through the Eustachian Tube into the middle ear and out through the perforation into the external ear canal. One can hear the sound of airflow and sometimes air bubbles are normally seen as the middle ear is wet with normal secretions.

4. You should get his ear examined by an ENT Specialist to confirm the above. You should get his hearing examined for any hearing loss. This is because a mild conductive hearing loss is usually expected which will go away after the eardrum heals. In case there is a sensorineural hearing loss, it has to be treated as soon as possible or it may become permanent. A few patients may get vertigo (dizziness) due to concussion.

5. Most traumatic perforations will heal on their own. Long term complications are rare. Healing is usually excellent. The ear should be kept dry. Infection should be prevented. Medication may be prescribed to achieve this. Regular check-ups to monitor the progress of the healing are required. In the rare case that the perforation is confirmed and does not heal, it may require an operative procedure to close the defect.

Hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Wish him a speedy recovery..

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