Beware When Joking in The Pool! - Eardrum Perforation

Eardrum Perforation / Injury / Bursting  Under Water

My patient came with ear pain that start after the trauma when joking in pool. After long-term swimming in the pool, simple external otitis can be considered in the first place, but ear trauma also changes the differential diagnosis firstly.

Eardrum Rupture in The Pool

The eardrum is located between the middle ear and the outer ear and has a certain degree of stretching during external pressure changes. In case of sudden pressure changes, tears in the eardrum can be seen. In particular, during the dive and dive, the external pressure increases during deep dive, and when the pressure in the middle ear drops below the external pressure, a pressure trauma to the eardrum occurs.

In the photo on the above, there is a bursting of the eardrum as a result of sudden pressure change while joking under water in the pool. Bloody areas in the outer ear canal and in the eardrum and traumatic perforation on the eardrum are seen. Many antibiotic resistant microorganisms can survive in pool waters (due to chemical disinfection rather than complete replacement of pool water and "stable water"). In addition, there are different side effects of chlorine in the pools which are disinfected with color.
Paper Patching For Tympanic Membrane Perforation
After 1 day after the trauma, the dead tissue around the hole in the eardrum was cleaned, and the antiseptic-impregnated paper patch was placed on the eardrum and a 2-month follow-up was planned. After the traumatic injury of tympanic mebrane, contact with the ear should be avoided until the hole in the membrane is closed.

In case the hole in the eardrum does not close during follow-up, an eardrum surgery is planned.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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