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The eardrum refers to the thin and flexible membrane which helps differentiate the outer ear from the middle ear. Doctors use the term ‘tympanic membrane’ to describe an eardrum.

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The eardrum is located between the outer ear canal and the middle ear. The middle ear in humans joins the cavities of the nose and throat (naso-pharynx) via a thin tubular structure called the Eustachian tube. This tube performs the function of maintaining the right pressure within the middle ear vis-à-vis the external air pressure. It also helps remove and discharge secretions in the middle ear and thus prevents the occurrence of varied ear infections.

Also called tympanic membrane retraction, a retracted eardrum is a condition which occurs when the eardrum is sucked or pulled into the region that is present behind it. This typically happens when the pressure occurring in the middle ear reduces considerably. The pressure inside the middle ear can drop suddenly due to any kind of rapid change in the air pressure present outside, thereby causing the eardrum to retract. However, most cases of retracted eardrums are caused by infections.

Both adults and children can suffer from a retracted eardrum. The condition is however more prevalent in children, especially in those children who are prone to developing frequent bouts of ear infections.

Symptoms of a retracted eardrum

Some of the common signs and symptoms of a retracted eardrum are listed below:

  • Increased hearing sensitivity is the most common symptom that is observed in patients.
  • Some affected individuals may elicit pain in ear.
  • Inward pulling of the eardrum causes sounds to seem louder than normal. Thus, most of the sounds heard by patients tend to be slightly louder than they are in reality. This feeling is somewhat similar to the one that people experience during pressure changes that occur when travelling by air.

A retracted eardrum, if left untreated, can result in the below mentioned medical complications:

  • Cholesteatoma:It is severe medical complication wherein a mass of skin gets trapped in the space of the middle ear. This harmful cyst can severely damage the eardrum. A growth or cyst that is as big as a tumor can erode the bones occurring in the middle ear, which may then lead to deafness or loss of hearing.
  • Development of retraction pockets: A retracted eardrum can facilitate the formation of empty pockets in the area of the middle ear. Such pockets are prone to debris accumulation, thereby increasing the risk of infections. Affected people may later suffer from chronic cases of ear infections.

Causes

In normal situations, the Eustachian tube helps maintain equal air pressure on both sides of the eardrum. Buildup of any kind of negative pressure behind the eardrum can cause it to retract. This is usually caused by Eustachian tube dysfunction or blockages, which in turn can occur due to the below listed reasons:

  • Any kind of ear infection is marked by accumulation of fluid in the inner ear or middle ear. Such fluid buildup can sometimes block the opening of the Eustachian tube in the ear, which then obstructs external air from entering the area of the middle ear, causes excessive negative pressure inside the ear, and ultimately leads to development of a retracted eardrum.
  • Eustachian tube dysfunction can cause the pressure inside the ear to become very low, thereby creating a vaccum in the area and triggering a retracted eardrum.
  • Inflammation or swelling of the sinuses, allergies, or infections of the upper airways can also cause blockages in the Eustachian tube.
  • Presence of tumors, growths, cysts, or abnormal masses in the naso-pharynx area can cause blockages in the Eustachian tube.

Treatment of a retracted eardrum

Most cases of a retracted eardrum are harmless. The Eustachian tube tends to clear out the varied blockages on its own; hence, medical treatment is normally not needed. However, a retracted eardrum comes with the possibility of deteriorating into cholesteatoma, a serious health complication. Hence, it is recommended to seek medical treatment for all instances of Eustachian tube obstructions and retracted eardrums. Medical treatment of these conditions can also help alleviate additional symptoms like ear pain, etc.

A few common treatment options are listed below:

  • Drug therapy and home remedies can help overcome Eustachian tube blockages caused by allergies, sinusitis, or upper airway infections. Pain and other associated symptoms can be eased with painkillers, antibiotic ear drops, nasal decongestants, and warm compresses.
  • Doctors may employ varied surgical options to get rid of infected retraction pockets or cholesteatoma.
  • Severe cases of Eustachian tube obstruction and retracted eardrum may be treated via drainage of fluids from the middle ear with the help of a tympanostomy ear tube.
  • The ‘valsalva maneuver’ may be used to relieve ear pressure and equalize internal and external pressure. One has to hold the breath and tighten the body, as done during a bowel movement, when performing this maneuver.
  • Air pressure within the ear can also be increased with activities like opening and closing the mouth or yawning. This can help equalize the pressure.

 

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