What is the medical name for traumatic eardrum hemorrhage?

Medical Name for Traumatic Eardrum Hemorrhage

The medical name for traumatic eardrum hemorrhage without perforation is hemotympanum or intratympanic membrane (iTM) hemorrhage, depending on the specific location of the blood. 1

Types of Traumatic Eardrum Hemorrhage

• Hemotympanum refers to both the presence of blood in the middle ear cavity and ecchymosis (bruising) of the tympanic membrane 1
• Intratympanic membrane (iTM) hemorrhage specifically describes bleeding that occurs between the tympanic membrane annulus and the epidermal layer, without perforation or middle ear cavity bleeding 1
• Both conditions fall under the broader category of intracranial hemorrhage, which includes any form of bleeding within the intracranial vault 2

Causes of Traumatic Eardrum Hemorrhage

• Blunt head trauma is a common cause of both hemotympanum and iTM hemorrhage 1, 3
• Barotrauma from activities such as scuba diving can cause iTM hemorrhage due to pressure changes 1
• Penetrating trauma to the ear canal can cause tympanic membrane damage and hemorrhage 3, 4
• Blast injuries can cause tympanic membrane damage with associated hemorrhage 3
• Spontaneous epistaxis (nosebleed) has been reported as a rare cause of iTM hemorrhage 1

Clinical Presentation

• Most common symptoms include otalgia (ear pain) and ear fullness 1
• Other symptoms may include tinnitus and hearing changes 1, 5
• Pure tone audiometry typically shows minimal or no conductive hearing loss in cases of iTM hemorrhage 1
• In hemotympanum with middle ear involvement, more significant conductive hearing loss may be present 6

Diagnostic Approach

• Otoscopic examination is the primary diagnostic method, revealing minor bleeding behind an intact tympanic membrane 1
• High-resolution CT scan of the temporal bone may be indicated to:
  • Confirm the diagnosis
  • Rule out temporal bone fracture
  • Assess for middle ear involvement
  • Evaluate the ossicular chain integrity 3, 2
• CT findings typically show thickening of the tympanic membrane without soft tissue density within the tympanic cavity in iTM hemorrhage 1

Management

• Most cases of iTM hemorrhage resolve spontaneously without specific treatment, usually within 1 month 1
• For hemotympanum:
  • Conservative management is typically recommended 6
  • Medical therapy may include observation and follow-up 6
  • In persistent cases with effusion, myringotomy and insertion of ventilation tubes may be considered 6
• If associated with tympanic membrane perforation:
  • Most traumatic perforations heal spontaneously within 6-8 weeks 4
  • Perforations lasting longer than 6 months after injury may warrant surgical intervention 3

Prognosis

• Excellent prognosis for iTM hemorrhage with complete spontaneous resolution in most cases 1
• Traumatic tympanic membrane perforations with hemorrhage from blunt injuries generally have good prognosis with spontaneous healing 3, 4
• Perforations from blast trauma, thermal or caustic injuries are less likely to heal spontaneously 3

Follow-up Recommendations

• Regular follow-up is recommended to monitor healing and rule out complications 4
• Biannual follow-up for at least two years is recommended for cases with tympanic membrane perforation due to risk of cholesteatoma formation 3