What causes tympanic membrane (eardrum) irritation after an ear irrigation (ear flush)?

From the Guidelines

Irritation of the tympanic membrane after an ear irrigation is most likely caused by the pressure of water against the sensitive eardrum tissue, creating inflammation, or the cleaning solution itself being irritating, as noted in the clinical practice guideline for cerumen impaction 1. When considering the potential causes of eardrum irritation after an ear flush, several factors come into play, including:

• The presence of a perforated tympanic membrane or patent tympanostomy tube, which limits the options available for cerumen removal and increases the risk of infection, pain, or ototoxic hearing loss 1
• The type of irrigation solution used, which can cause infection, pain, or ototoxic hearing loss, depending on its composition 1
• The potential for caloric effects resulting in vertigo if irrigation is used in the presence of a perforated tympanic membrane 1 To manage eardrum irritation after an ear flush, it is essential to:
• Avoid further ear cleaning and allow the eardrum to heal naturally
• Use over-the-counter pain relievers like acetaminophen or ibuprofen to manage discomfort
• Apply a warm compress to the outside of the ear to reduce pain and inflammation
• Keep the ear dry to prevent infection It is crucial to seek medical attention if symptoms persist or worsen, as they could indicate a more severe condition, such as a perforated eardrum or infection 1.

From the Research

Tympanic Membrane Irritation after Ear Irrigation

• The provided studies do not directly address the causes of tympanic membrane irritation after an ear irrigation (ear flush) 2, 3, 4, 5, 6.
• However, some studies discuss the treatment and management of ear infections and tympanic membrane perforations, which may be related to ear irrigation 2, 4, 5, 6.
• Traumatic tympanic membrane perforations can be caused by various factors, including blunt and penetrating trauma, blasts, thermal or caustic injuries 4.
• The use of topical antibacterial agents, such as ofloxacin otic solution, can be effective in treating ear infections and promoting healing of the tympanic membrane 2, 5.
• It is possible that ear irrigation may cause irritation or damage to the tympanic membrane, especially if not performed properly or with excessive force.
• Further research is needed to specifically investigate the causes of tympanic membrane irritation after ear irrigation.