What is an injected eardrum (tympanic membrane)?

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From the Guidelines

An injected eardrum refers to a condition where the tympanic membrane (eardrum) appears red, inflamed, and has increased blood vessel visibility due to inflammation, typically occurring during an ear infection, particularly acute otitis media, as noted in the clinical practice guideline update by 1. This condition is often accompanied by ear pain, hearing loss, fever, and sometimes drainage if the eardrum ruptures. The eardrum becomes "injected" with blood as blood vessels dilate in response to infection or inflammation. Treatment usually involves antibiotics such as amoxicillin for bacterial infections, as well as pain relievers like acetaminophen or ibuprofen to manage discomfort, and warm compresses applied to the outside of the ear may provide additional relief, as suggested by 1. The inflammation occurs because the body sends increased blood flow to the area to fight infection, causing the characteristic redness and swelling. Most cases resolve with appropriate treatment, though severe or recurrent cases may require evaluation by an ear specialist to prevent complications like hearing loss or spread of infection, as indicated by 1 and 1. It's essential to differentiate between otitis media with effusion (OME) and acute otitis media (AOM) to avoid unnecessary antimicrobial use, as emphasized in the guideline by 1 and 1. Pneumatic otoscopy is the primary method for diagnosing OME due to its high sensitivity and specificity, as noted in the evidence report by 1. In cases where watchful waiting is considered, regular check-ups and hearing tests are necessary to monitor the condition, as outlined in the shared decision grid by 1. Overall, the management of an injected eardrum should prioritize the prevention of complications and the improvement of the patient's quality of life, as recommended by the clinical practice guidelines 1.

From the Research

Definition of Injected Eardrum

  • An injected eardrum refers to the presence of fluid or inflammation in the middle ear, which can cause the eardrum to appear red or swollen.
  • This condition is often associated with middle ear infections, such as otitis media, which can be caused by bacterial or viral infections 2.

Causes of Injected Eardrum

  • Middle ear infections, such as otitis media, are a common cause of injected eardrum 2.
  • Other causes can include eustachian tube dysfunction, allergies, or colds 2.
  • Intratympanic steroid injections can also cause tympanic membrane breakdown or perforation, especially in susceptible ears, such as those with a history of irradiation 3, 4.

Symptoms of Injected Eardrum

  • Pain or discomfort in the ear
  • Fever
  • Hearing loss or difficulty hearing
  • Feeling of fullness or pressure in the ear
  • Redness or swelling of the eardrum

Treatment of Injected Eardrum

  • Antibiotics may be prescribed to treat bacterial infections 2.
  • Pain relief medications, such as paracetamol or ibuprofen, may be used to manage symptoms 5, 6.
  • In some cases, surgical intervention, such as tympanoplasty, may be necessary to repair a perforated eardrum 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Pharmacotherapy of otitis media.

Pharmacotherapy, 1991

Research

Tympanic membrane breakdown after intratympanic injection of steroids in irradiated ears.

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2007

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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