Differential Diagnosis for Ruptured Tympanic Membrane in a 19-year-old Girl
- Single most likely diagnosis:
- Trauma (e.g., direct blow to the ear, explosion, or insertion of objects into the ear canal): This is the most common cause of a ruptured tympanic membrane, especially in young adults who may be more prone to accidents or risky behaviors.
- Other Likely diagnoses:
- Middle ear infection (otitis media): Severe or untreated infections can lead to the rupture of the tympanic membrane.
- Eustachian tube dysfunction: Problems with the Eustachian tube, which regulates air pressure in the ear, can lead to increased pressure and potentially cause the tympanic membrane to rupture.
- Barotrauma (e.g., from scuba diving or air travel): Sudden changes in air pressure can cause the tympanic membrane to rupture.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Temporal bone fracture: Although less common, a fracture of the temporal bone can cause a ruptured tympanic membrane and may be associated with more severe complications, including facial nerve paralysis or cerebrospinal fluid leakage.
- Cholesteatoma: A rare skin cyst in the middle ear that can cause destruction of the surrounding bone and tissue, potentially leading to a ruptured tympanic membrane and other serious complications.
- Rare diagnoses:
- Otosclerosis: A rare condition characterized by abnormal bone growth in the middle ear, which can cause a ruptured tympanic membrane.
- Relapsing polychondritis: A rare autoimmune disorder that can cause inflammation and damage to the cartilage in the ear, potentially leading to a ruptured tympanic membrane.