From the Guidelines
For a ruptured tympanic membrane, the primary treatment is to keep the ear dry and allow it to heal naturally, using antibiotic ear drops such as ofloxacin to prevent infection, as recommended by the most recent guidelines 1. When managing a ruptured tympanic membrane, it is essential to prioritize preventing infection and promoting a conducive environment for healing.
- Gently clean the outer ear with a soft cloth, avoiding water entry into the ear canal.
- Use antibiotic ear drops, such as ofloxacin, 5 drops twice daily for 7-10 days, to prevent infection, as this has been shown to be effective in preventing infection in patients with a non-intact tympanic membrane 1.
- For pain management, take over-the-counter pain relievers like ibuprofen (400-600 mg every 6-8 hours) or acetaminophen (500-1000 mg every 4-6 hours).
- Avoid inserting anything into the ear, including cotton swabs, to prevent further damage and infection. During the healing process, which typically takes 6-8 weeks,
- Refrain from swimming and protect the ear from water during showers using a waterproof ear cover or petroleum jelly-coated cotton ball.
- If symptoms worsen, fever develops, or healing doesn't occur within 2 months, consult an ENT specialist. In some cases, particularly for large perforations or those that don't heal on their own,
- Surgical repair (tympanoplasty) may be necessary, with cartilage grafts showing fewer postoperative tympanic membrane perforations compared to temporalis muscle fascia tympanoplasty 1. This conservative approach allows most tympanic membrane ruptures to heal without complications while preventing further damage and infection.
From the FDA Drug Label
Chronic Suppurative Otitis Media with perforated tympanic membranes The recommended dosage regimen for the treatment of chronic suppurative otitis media with perforated tympanic membranes in patients 12 years and older is: Ten drops (0.5 mL, 1. 5 mg ofloxacin) instilled into the affected ear twice daily for fourteen days.
The treatment for a ruptured (perforated) tympanic membrane is ofloxacin otic solution, with a recommended dosage of 10 drops (0.5 mL, 1.5 mg ofloxacin) instilled into the affected ear twice daily for 14 days in patients 12 years and older 2.
From the Research
Treatment for Ruptured Tympanic Membrane
The treatment for a ruptured (perforated) tympanic membrane typically involves keeping the affected ear dry and may include:
- Oral and topical antibiotics for perforations related to acute otitis media 3
- Avoiding irrigation and pneumatic otoscopy 3
- Suctioning out blood, purulent secretions, and other debris from the canal 3
- Describing the perforation size and location 3
Medical Interventions
Medical interventions may include:
- Ofloxacin otic solution, which has been shown to be effective in treating ear infections, including those with perforated tympanic membranes 4, 5, 6, 7
- Gelatin sponge patching, which may serve as an effective and inexpensive treatment strategy for traumatic large tympanic membrane perforations 4
- Topical administration of ofloxacin otic solution, which produces high concentrations of the drug in the ear and is well tolerated 5
Healing Outcomes
Healing outcomes for traumatic tympanic membrane perforations may be improved with the use of ofloxacin otic drops, which can shorten the closure time and improve the closure rate 4, 6, 7
- The closure rate and closure time may vary depending on the size and location of the perforation, as well as the treatment used 4, 6
- Ofloxacin use in patients with traumatic tympanic membrane perforation is effective in reducing healing time and increasing the rate of tympanic membrane perforation closure 7