Perforated ear drum - how long off flying?

[Kaptin M]

A colleague, living in Japan, was recently diagnosed with a perforated ear drum - due to an inner ear infection. The doctor - an ENT specialist - initially told him it was okay to continue flying, :uhoh: however past anecdotages have led me to believe that he should be off for somewhere between 4-6 weeks.

Fortunately he got a second opinion, however THAT guy told him 10 days would be enough.

Would anyone care to throw in their tuppence worth?

[Chimbu chuckles]

Hey M....last time I perforated an ear drum, falling off a motorbike and banging my, thankfully helmeted, head on the road, the doc wouldn't give me any time off work.

Didn't seem to slow the healing process and I noticed no undue side effects...healed in about 4 to 6 weeks.

Chuck.

[jtr]

KNow of two guys that have doen it, and both were off for about 6 weeks

[Flyin'Dutch']

Typically an eardrum takes only 7-10 days to heal up in these cases (as in non traumatic perforation)

However the thing is that you need to be sure it is healed up and you can only do that by having a look!

FD

[QDMQDMQDM]

Why should a perforated eardrum, in itself, necessarily be a contraindication to flying? By definition, there will be no problem with pressure equalisation in the middle ear and so what other problem could it give?

I'm interested to hear the definitive answer on this.

QDM

[Bad medicine]

A perforated ear drum (tympanic membrane) will usually heal on its own in 4-6 weeks. However, it won't heal while there is ongoing infection, and this has to be brought under control first. Depending on where in the drum that the perforation occurs, it may require surgery to heal the defect, but this is usually not required.

It is certainly not advisable to return to flying until the drum is healed, and this can only be determined by examination, preferably by an ENT specialist.

[Bad medicine]

My understanding is that a perforated TM is a fairly strong relative contraindication (how's that for hedging your bets) to flying duties, for a couple of reasons.

Healing may be delayed due to the constant changes in pressure, and therefore airflow through the defect. There may also be re-perforation when these pressure differentials are applied across a scar which is incompletely consolidated and therefore not full-strength.

Perforated TM is a risk for middle ear infection, which may be sub-clinical initially.

Finally, there is a theoretical risk of alternobaric vertigo, due to the differential in pressure between the 2 ears (the perforated side will always be at ambient, while the intact side will almost never be) being transmitted to the vestibular systems.

Any other thoughts anyone?

Cheers,

BM

[QDMQDMQDM]

Those seem like pretty robust reasons, BM. Re-perforation of a partially healed drum seems very convincing. Never heard of alternobaric vertigo before, but shall henceforth use the term with abandon!

QDM

[Kaptin M]

Thanks for the replies all - sorry to hear about the accident, Chuck, we hope the bike made a full recovery :}

Another question I'd like to ask on this guy's behalf (he's off on vacation leave at the moment) - If he were to return to flying before the membrane had "rejoined", would the constant changes in pressure cause scar tissue to form? And would this result in a hearing loss?

Thanks for your indulgence in a topic that could perhaps have an effect on our careers as air crew, both cockpit and cabin.

[Bad medicine]

I would advise him not to go back to flying until healing was complete. The formation of scar tissue is part of the healing process. If healing isn't complete, the changes in pressure may delay or prevent healing, perhaps requiring a surgical procedure to repair the perforation.

[Flyin'Dutch']

BM,

Can I just take issue with your statement:

and this can only be determined by examination, preferably by an ENT specialist.

As I am of the opinion that even some lesser gods can determine whether a drum is intact or not!

ho hum

FD

[Bad medicine]

I absolutely agree with you that most of us could pick a perfed TM and its healing. But unfortunately, in today's world of defensive medicine, specialist opinions hold more weight in the courts. If the pilot is sent back to work and re-perforates, then makes a claim, where do we stand? I know it's blame shifting, but that is the way it works, at least in Aus at the moment.

Cheers,

BM

[Gerund]

Some lucky folk have a congenital perforation of the eardrum. With this condition scuba diving is clearly contraindicated but they can blow smoke out their ears.

Not quite on topic, but you may like to tell your colleague that he has a rare opportunity, after a little practice, to amaze friends with his new trick.

If he doesn't smoke, opportunity lost.

[ausdoc]

I used to know a guy who could blow smoke out of his ears. Very impressive at the pub after a few drinks. He'd pretend he was angry, and out the smoke would come. Can't be very good for your middle ears I wouldn't think.:D

[Kaptin M]

Does that mean it is also possible to breathe through one's ears?
Combined with the ability to lick one's eyebrows, I imagine it could be quite a popular attraction for some ladies. :O

[Kaptin M]

A final update on this one, as I see another thread has opened, running along the same lines.

All up, the subject under discussion was off for only about 3 weeks - approx. 1/2 the time that I originally thought he would need, from previous discussions on the subject, with others.
At the end of this time, the ENT Specialist took a couple of photos of his eardrum to prove that the membrane had regrown/rejoined.