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Dr. Andrew Rynne

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Suggest treatment for pain and bleeding from the ear post injury

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Dr. Riddhi Shah

ENT Specialist

Practicing since :2008

Answered : 507 Questions

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Posted on Wed, 8 Mar 2017 in Ear, Nose and Throat Problems
Question: Hello,

I landed on part of a toy that was long and skinny and it went into my ear and tore my eardrum. It began to bleed about 2 hours later so I went to the ER where perforation was confirmed and I was given Neomycin/Polymyxin B eardrops. I used the drops once (3 drops) and then read those drops should not be used in ears with perforated eardrums as they are very ototoxic and can cause permanent tinnitus, hearing loss and balance issues. I am so scared now. Am I at risk for damage since I put these drops in? I have developed a mild tinnitus about a day after putting the drops in and it has gotten a bit worse since it started. Can tinnitus develop a day or two after sustaining injury to eardrum? Or is it possible this is a result of the drops? I am very worried. If there is possibility of damage from the drops, can I do something to slow the progression? I've read taking steroids right away can help. Is this true?
doctor
Answered by Dr. Riddhi Shah 3 hours later
Brief Answer:
Please see the answer.

Detailed Answer:
Hi,thank you for posting your query on HealthcareMagic.

I have gone through your query and can understand your concern.

The tinnitus which you are feeling might be like a whistling sound,which might occur due to air passing through the traumatic ear drum perforation(hole).There is a greater possibility of tinnitus like this in a traumatic ear drum perforation.This type of tinnitus will usually stop after you close your ear with a cotton plug.
Please let me know whether you have similar type of tinnitus and is there a reduction/stopping of tinnitus after closing your ear canal with a cotton plug.

The chances of tinnitus occuring with the single time use of Neomycin/Polymyxin ear drops seems less likely as generally such ear drops can occasionally affect the hearing nerve causing tinnitus or reduced hearing if administered over a long period of time in a person with a perforated ear drum.Also if the tinnitus is due to the use of such ear drops,it will generally go way in few days after discontinuing the ear drops.The role of steroids is uncertain in this case.There are very less chances of permanent damage in the ear by the use of such ear drops for just one time.So,please don't worry.

In a case of Traumatic ear drum perforation,if the injuring object was dirty,then only you should use Antibiotic ear drops like Ciprofloxacin to prevent infection.
If this is not the case and if there is no discharge occuring from ear,then there is no indication to use ear drops.

It would also be advisable to have a hearing test called Pure tone Audiogram.It will help to find out the type and severity of hearing loss.Generally in traumatic ear drum perforation,there is mild hearing loss.If the hearing loss is more,then there are chances of Medium to large sized traumatic ear drum perforation(which may not heal on its own) or Ossicular damage(middle ear bone disclocation )due to trauma,in which surgery is needed.

Generally the traumatic ear drum perforation will usually heal within 6-8 weeks.Surgery to close the ear drum perforation might be needed if the perforation does not heal on itself after 8 weeks or if there is a greater hearing loss suggestive of Ossicular bone damage.

During the healing period,keep ear dry.Don't allow water to go inside while taking bath.you can use ear plugs to prevent water going inside ear.Also don't use anything to clean your ear by self.Avoid loud sounds.Also avoid cold food and dust.

Hope this answers your question.I would be happy to answer if you have further questions.Take care.


Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Riddhi Shah 1 hour later
Thank you so much for your lengthy response. I can still hear the tinnitus when I plug my ear, even more so than when it's not covered, in fact. Would this indicate that the tinnitus is due to something than the eardrum perforation? I've read that Neomycin based ear damage is permanent and can start with tinnitus.
doctor
Answered by Dr. Riddhi Shah 38 minutes later
Brief Answer:
Please see the answer

Detailed Answer:
Hi,thank you for your reply.

Still,I think the cause of Tinnitus seems to be the traumatic ear drum perforation as compared to the use of neomycin-polymyxin B ear drops for just one time.You are right that the ototoxicity of Neomycin may start with tinnitus.But it is generally in a case of systemic use of injection neomycin or long term use of neomycin ear drops.

There is a high probability that the Tinnitus will gradually go away.

You may start using Antioxidant medicines.They might help.

It would be advisable to consult an Otolaryngologist Doctor for examination of the size of your ear drum perforation and also have the hearing test done,if not done previously.

Take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Riddhi Shah 9 minutes later
Ok, great! Is it unusual for the tinnitus not to start until a day or two after perforating the eardrum? Or is that normal? The tinnitus didnt start untila day later, around the same day my ear stopped bleeding. I will certainly look into an antioxidant medicine.
I have only been to the ER so far but have an ENT appointment coming up.

Thank you!
doctor
Answered by Dr. Riddhi Shah 39 minutes later
Brief Answer:
Please see the answer

Detailed Answer:
Hi,thank you for your follow-up question.

Tinnitus might start after a day or two after Traumatic ear drum perforation.

Please get consulted with an Otolaryngologist Doctor for ear examination.

Take care.


Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Riddhi Shah 5 hours later
I have one more question! Can tinnitus from traumatic ear drum perforation continue to get louder everyday once it starts? Mine seems to be getting louder and more high-pitched and is very bothersome. I thought it might stay the samd volume.
doctor
Answered by Dr. Riddhi Shah 7 hours later
Brief Answer:
Please see the answer

Detailed Answer:
Hi,thank you for your follow-up question.

Tinnitus due to a traumatic ear drum perforation may feel louder than before when we give more attention to the tinnitus sound and listening to loud sound can also cause an increase in the intensity of tinnitus.

Avoid talking over the phone with the ear having ear drum perforation.
You can listen to White noise music (available online) as it has masking effect on Tinnitus.

Hope this answers your question.Take care.
Above answer was peer-reviewed by : Dr. Prasad
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