From the Guidelines
A cyst on the tympanic membrane requires prompt medical evaluation by an ENT specialist, and surgical removal is often necessary to prevent complications such as hearing loss, facial nerve damage, or infection spreading to the brain. The condition is typically a cholesteatoma, which contains skin cells and debris that can grow and damage surrounding structures 1. Symptoms may include hearing loss, ear drainage, pain, or dizziness.
Key Considerations
- Cholesteatomas develop when skin cells become trapped in the middle ear, often due to chronic ear infections, eustachian tube dysfunction, or previous ear surgery 1.
- Treatment usually involves surgical removal, and the surgeon will determine the appropriate surgical approach based on the cyst's size and location.
- After surgery, follow-up appointments are essential to monitor healing and prevent recurrence.
- While waiting for medical care, it is crucial to avoid inserting anything into the ear canal and keep the ear dry.
Important Evidence
- According to the clinical practice guideline: otitis media with effusion 1, surgical candidacy for OME depends largely on hearing status, associated symptoms, the child’s developmental risk, and the anticipated chance of timely spontaneous resolution of the effusion.
- Tympanostomy tubes are recommended for initial surgery because randomized trials show a mean 62% relative decrease in effusion prevalence and an absolute decrease of 128 effusion days per child during the next year 1.
- Adenoidectomy plus myringotomy (without tube insertion) has comparable efficacy in children aged 4 years or older, but is more invasive with additional surgical and anesthetic risks 1.
Recommendations
- Do not attempt to treat this condition at home, and seek medical evaluation by an ENT specialist as soon as possible.
- Follow the surgeon's instructions for post-surgical care to ensure proper healing and prevent complications.
- Attend all scheduled follow-up appointments to monitor healing and prevent recurrence.
From the Research
Cyst on Tympanic Membrane
- A cyst on the tympanic membrane is a rare entity, with limited information available in the medical literature 2.
- One case study reported a serous cyst in the posterior-inferior quadrant of the right tympanic membrane, which was removed with a transcanal tympanoplasty 2.
- The origin of such a cyst is unclear, and further research is needed to understand its embryologic and anatomic background 2.
Treatment and Management
- Myringotomy, a surgical incision in the tympanic membrane, can be used to access the middle ear for sampling, flushing, and instilling topical therapy 3.
- The use of topical steroids, such as ciprofloxacin/dexamethasone, may increase the risk of residual tympanic membrane perforation and subsequent tympanoplasty 4.
- Gelatin sponge patching and ofloxacin otic solution may be effective treatment strategies for traumatic large tympanic membrane perforations 5.
Tympanic Membrane Perforation and Repair
- Traumatic large tympanic membrane perforations can be treated with gelatin sponge patching, ofloxacin otic solution, or spontaneous healing 5.
- The closure rates and healing times for these treatments vary, with ofloxacin otic solution showing the highest closure rate and shortest healing time 5.
- Revision tympanoplasty, including anterior perforations and lateralization of grafts, can be used to repair perforated tympanic membranes 6.