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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had perforation in ear due to loud noise. Prescribed Mucodyne and Algeria. What causes crackling sound in ear?

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Dr. Prahlad Duggal

ENT Specialist

Practicing since :1998

Answered : 784 Questions

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Posted on Tue, 10 Dec 2013 in Ear, Nose and Throat Problems
Question: Dear Doctor I had a perforation to my left ear 4 months back which resulted due to loud noise and a blow. I had been to a ENT where I was prescribed with mucodyne and Algeria capsules. my perforation was heald in a week or so. However I still have a mild ringing and ear crackling sound each time I sowllo or yawn. the crackling some times noticed in the other ear which is normal. a few days back I underwent audogram and the reports are normal as confirmedby doctor please help...
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Answered by Dr. Prahlad Duggal 33 minutes later
Brief Answer: With time the problem should be resolved Detailed Answer: Hi, Thanks for your query. You have a healed perforation in your left ear. Traumatic perforation often heal without any intervention but the healed area is usually thinner than the normal tympanic membrane which may or may not regain its normal thickness. Normal tympanic membrane consists of three layers but a healed membrane (TM) many a times lacks membranous layer. Because of this it remains thin and hypermobile. This hypermobile area moves more with yawning or swallowing than the normal thickness TM and produces crackling sound. The ringing sound is because of the stunning or damage to inner ear and it can be temporary or permanent. A short course of steroids can be taken in consultation with the doctor and it does help in some patients but not all. Also betahistine tablets can be taken in consultation with your doctor for this. Otherwise with time the ringing sensation sometimes improves on its own. The crackling sound mostly improves as with time the healed area gains strength but if it does not, that thinned segment can be excised and replaced with a graft. This is not necessary in most of the cases. As your audiogram is normal, most probably the thickness will be normal or will become normal with time. Wish you good health. Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Prahlad Duggal 32 minutes later
thanks for your kind response! please confirm if I should under go impedance audiometry? or will there be any scope for fluid collection? thanks
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Answered by Dr. Prahlad Duggal 1 hour later
Brief Answer: Your history does not favour a fluid in ear Detailed Answer: Hi, Thanks for the query. Please go for an ENT examination. An ENT can decide if there is a need for impedance audiometry. A clinical examination with valsalva or with pressure otoscopy will show a hypermobile area and then an impedance audiometry can document that. My explanation for your questions is: 1. Impedance audiometry involves giving pressure during testing and a very thin healed are can get perforated. 2. A small area which is hypermobile will not give an increased compliance and if there is big area which is thin and healed, it should have given a conductive hearing loss, which your audiometry is not revealing. 3. A fluid in middle ear gives a conductive hearing loss which your audiometry is not revealing. 4. There can be collection of fluid/blood in the ear post trauma but not usually in a perforation situation. Even if it is there, a healed perforation goes against this as a collection inside does not allow healing. A blood clot can help in healing but will be visible clinically and will also give a conductive hearing loss. Please feel free to ask another query. Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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