Temporal bone fracture with tympanic membrane perforation and hemorrhage. (Otoscopic Clinic).
This otoscopic view of a left ear demonstrates an elliptical perforation immediately posterior to the malleus and hemorrhage involving the anterior portion of the pars tensa. This patient had sustained a temporal bone fracture with perforation and bleeding. The tympanic membrane completely healed spontaneously after 4 weeks without treatment. Immediate management involves an antibiotic to prevent secondary infection, and the patient is advised to prevent water from entering the ear. Approximately 90% of traumatic perforations heal spontaneously. Should a perforation persist after 4 to 6 weeks, myringoplasty or tympanoplasty can be performed, which is successful in 95% of cases.