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Fever, ear infection, hole in the ear drum. Which medicine will help?

My ear drum had a hole about three years back and I took some medication ( antibiotics ) and it cured by itself after some time . Now about two week back I had fever and my ear again got infected and the hole reoccurred in the ear drum. Since there is no specialist hospital and doctors are available in Muscat I require your specialist advice if you can. Is there any treatment with medicine available? The local ENT doctor ask me to go for surgery. I just want your advice.
Asked On : Thu, 13 Dec 2012
Answers:  1 Views:  121
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ENT Specialist 's  Response
Hello and a healthy welcome to HCM,
HCM sent me few questions to be answered and I picked up your question and went through it repeatedly and very carefully. I found it to be question of real importance.
As far as i can make out, you are concerned about whether to undergo surgery or not ?
Anyway, if you allow, let me first go to a little bit details of your condition and the disease. Let me concentrate in the particular line ----"My ear drum had a hole about three years back" & "Now about two week back I had fever and my ear again got infected and the hole reoccurred in the ear drum". That means you had perforation of your drum once and it has been treated with medication, also there is NO problem within these 3 years until last 2 weeks back. From these i think that your perforation might have healed earlier as a small perforation takes maximum of about approx 3 months to heal. If the perforation would not have healed, you would have got ear discharge within this 3 years. Generally, a healed perforation is weak, so it might have undergone re perforation when got infected.
Now, i want to come to your question of concern..i.e., -
"Is there any treatment with medicine available? The local ENT doctor ask me to go for surgery. I just want your advice."

Answer - YES

Wait...wait...answer is not completed. More interesting lines are below. Please read carefully.

Yes...medication is available. Straight away if i had to answer after getting an idea from your history..i would say yes. I myself have treated many of my patients with ear drum perforation with drugs. No special drug needed...just the antibiotics/antihistaminic/decongestants. This is not a big deal for mild size perforation. Main line of treatment for treating a perforated ear drum is not medication but protecting it from infection from sources both inside & outside.i.e., from nose/respiratory tract infection and also from outside dust and water .etc. You have to strictly protect your ear from water entry. This way it might take upto 12 weeks to completely heal, but it heals in a natural way.
NOW, please read the following line carefully....major part of the answer lies below.
In your condition -
* Once there was perforation (hole), now re-perforation has occurred.
* It has perforated following an MARGIN of the hole is very important to take into account and also the SIZE of the hole
If the size of hole is big and the margin has epithelial growth, then MEDICINE IS WORTHLESS and will not heal, as per my experience goes. Here SURGERY (Myringoplasty/Type 1 Tympanoplasty) is essential.
OK...OK....Let me stop the explanations here, or you will get confused.

Let me just try to say it in single line - Go for surgery if large non healing hole.

I agree that lot of questions might have aroused in your mind but without any clinical examination and only reading the history provided by you, i think (strictly from my personal opinion)...although there is YES to the medicine treatment..there is a BIG YES to surgery.

Please do not worry, have faith on Almighty and on the Doctor who have examined you and advised Surgery.
I have made a humble effort to deal with your question and i sincerely hope that i could at least ease some of your mental turmoil if not all.
I wish you a Merry Christmas and wish you a very very Happy and Healthy life ahead.
Thanks and take care
Answered: Tue, 25 Dec 2012
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