Question

Can a perforation in the eardrum caused by purulent mastoiditis heal?

Answer

Infants have a strong ability to self-heal, and their eardrums typically seal up within 10 to 15 days. However, the possibility of healing a perforated eardrum depends on specific circumstances, especially if there are factors like chronic inflammation.

  1. Acute purulent mastoiditis: After a perforation, if treated promptly and correctly, including cleaning the pus with hydrogen peroxide, applying antibiotic drops to the ear, and using systemic antibiotics, the perforation usually seals up within 10 to 15 days.
  2. Chronic purulent mastoiditis: If the perforation is small and the discharge is intermittent, and the ear remains dry for longer periods, the eardrum may seal up on its own. However, if chronic mastoiditis leads to larger perforations and pus accumulation, the eardrum usually does not seal up, and some patients may have long-term discharge. Therefore, proper treatment and care can help the eardrum heal. If not treated promptly, it may lead to conductive hearing loss. Precautions include avoiding water in the ear, avoiding spicy or irritating food, maintaining good hearing, keeping the environment quiet, avoiding excessive exercise, maintaining oral hygiene, breathing through the nose as much as possible, lying on the side with the affected ear down when sleeping, not blowing nose too hard, and moderate exercise to help keep the nasal passages and eustachian tubes clear. This maintains the middle ear’s metabolic and ventilation functions. If there is a fever and nasal congestion, treatment should be sought early to prevent worsening of otitis media. In cases of chronic mastoiditis with an eardrum perforation, special attention should be paid to preventing unclean water from entering the middle ear. Earplugs may be used if necessary. If water enters the ear, it can be dried with a hairdryer or by tilting the head to allow moisture to drain out. Avoid picking at the ear to prevent further injury.