Tho has a history of chronic otitis media. In the last three months, her symptoms worsened, including foul-smelling ear discharge and tinnitus. An otoscopy at Tam Anh General Hospital in Ho Chi Minh City revealed a large perforation in her right eardrum.

Doctor Pham Thi Phuong, from the ENT Center, diagnosed Tho with otitis media with eardrum perforation. Eardrum perforation is a complication of chronic otitis media that recurs frequently and is not treated promptly and properly. The inflammation and pus accumulation in the tympanic cavity (middle ear) over time increases pressure on the eardrum, eventually causing it to perforate to allow pus to drain out and relieve pressure in the middle ear. If the eardrum is not repaired, the patient's hearing may decrease, and the infection can lead to the formation of a cholesteatoma in the middle ear, eroding the mastoid bone, degenerating the middle ear mucosa, and potentially affecting the brain.

The doctor treated the infection and then performed endoscopic eardrum repair surgery. The surgical team cleaned the inflamed tissue and trimmed the edges of the eardrum. Then, they took a thin piece of muscle fascia from behind the ear and placed it over the perforation to reconstruct the eardrum. This patch was secured with dissolvable medication to help the new eardrum adhere firmly. Merocel (a soft, sponge-like material) was placed in the ear to stabilize the surgical site.

Doctor Phuong (seated) performing endoscopic eardrum repair on Tho. Photo: Tam Anh General Hospital

Doctor Phuong (seated) performing endoscopic eardrum repair on Tho. Photo: Tam Anh General Hospital

Two days after the surgery, Tho was discharged in stable condition. For two weeks post-surgery, she needed to maintain a nutritious diet, rest adequately, avoid blowing her nose forcefully, keep her ear dry, avoid lying on the operated ear, stay away from loud noises, avoid strenuous activity, refrain from swimming, and avoid flying.

At her follow-up appointment one week later, the surgical site was healing well, with no swelling, pain, or discharge.

Children are more susceptible to otitis media than adults because their Eustachian tubes are shorter, narrower, and more horizontal. Symptoms include earache, ear discharge, pus drainage from the ear, foul-smelling ear, fever, headache, and loss of appetite. If any unusual signs appear, parents should take their child to an ENT specialist for diagnosis and appropriate treatment.

Preventative measures include washing children's hands frequently with soap, not sharing eating utensils, teaching children to cover their mouths when coughing or sneezing, breastfeeding for at least the first 6 months, vaccinating against ear infections caused by pneumococcal bacteria and influenza, and keeping children warm in cold weather to boost their resistance.

Uyen Trinh