H72.13

Clinical Causes: Middle ear infections (otitis media) leading to pressure build-up and perforation Trauma to the ear, such as a blow or sudden change in pressure Chronic ear infections causing weakening of the tympanic membrane Sudden loud sounds or explosions causing a tear Inserting objects into the ear canal, leading to injury Barotrauma from diving or flying, which causes pressure imbalance

Key Symptoms: Hearing loss in both ears Ear pain or discomfort A feeling of fullness or pressure in the ears Popping or ringing sounds (tinnitus) Fluid or pus draining from the ear Dizziness or balance problems in some cases

Diagnosis Path: A healthcare provider will examine the ear using an otoscope, a device with a light to look into the ear canal and eardrum. During the examination, the provider looks for visible perforations or tears in the attic portion of the tympanic membrane. Additional tests such as audiometry may be performed to assess hearing levels, and imaging studies like a CT scan might be ordered if there is suspicion of associated issues with the middle ear or surrounding structures. Proper diagnosis is crucial to determine the extent of damage and appropriate treatment options.

Treatment Protocols: Management of bilateral attic perforation usually involves a combination of approaches, depending on the severity and cause. Treatments may include: - Observation and monitoring for small perforations, as some heal naturally over time - Antibiotic ear drops or oral medications to treat or prevent infections - Keeping the ear dry and avoiding inserting objects or liquids into the ear - Surgical interventions such as tympanoplasty to repair the perforated eardrum, especially if the perforation persists or causes significant hearing impairment - Addressing underlying causes, such as controlling infections or preventing trauma Regular follow-up with an ear specialist (otolaryngologist) is advisable to assess healing progression and manage any complications.