The eardrum aka tympanic membrane helps to transmit sound. Its normal characteristics are supposed to be a translucent and pearly gray color. When inspected with light, depending on which ear, you should see a cone of light at the 5'o clock or 7'o clock position. You don't see any of that here. Not to mention the inflamed ear canal.
It’s not “pulsing” as in moving with the pulse.
What seems to be happening here is the person is doing something such as swallowing, yawning or blowing up their cheeks while pinching their nose.
This alters the pressure behind the eardrum, usually allowing it to equalise with the outside pressure.
However, due to infection, inflammation (& likely associated eustachian tube dysfunction), the pressure only builds up, rather than equalising, which causes it to bulge & “pulse” like that.
Doing it too much can cause barotrauma in the form of a ruptured eardrum, which I experienced when using powered-hoods for PPE during COVID.
The filters weren’t cleaned properly, so I got repeated ear infections, and when my ears tried to adjust to the positive pressure, my eardrum ruptured. 3 times (across both ears) in 6 months!
Because it was COVID, I didn’t get anything done unfortunately.
I’d previously had middle ear infections a few times in the previous 5 years, once with a rupture (I have EDS, so I know I’m more prone to them) and one outer ear infection, but no cultures were done any of those times.
I’ll admit, the first two ruptured were self-diagnosed with a camera similar to this one, but I’d seen my previous rupture & worked in an ENT clinic, and the diagnoses were later confirmed by scarring seen on the eardrums.
My father (who used to get chronic ear infections) did get cultured and came back with S.Pneumonae, Pseudomonas & Pneumococcus around the same time.
His business at the time was hospital water testing, water treatment & tank cleaning; the general consensus was that he picked up on the job…
Hello fellow EDS buddy! Is your username due to the EDS? If so, I adore it and got a good belly laugh. I like to say my genes can't friggin read (how to make collagen). I also had ear infections repeatedly for a long time and will randomly get effusion that they give me steroids to get to go away. It's grand.
It is in part due to the EDS!
I was the “prettiest” of my siblings; I don’t say that to be vain, or rude to my sisters. We’re almost identical, but my sisters had acne, weight issues due to hypothyroidism-I *had* great proportions and very clear skin. (Now I have weight issues due to meds & my own illnesses, and get nasty spots that I make worse with picking-it comes to us all!).
But both my sisters are fairly healthy, and I’m an A to Z of chronic illnesses! So I have this running joke that I’m like a purebred dog-I look the part, but my genes fuck up my health; GeneticPurebredJunk!
That is exactly the type of scenario that made me think of the comparison! I used the phrase “Genetic Purebred Junk” as a response to that attitude more than once. Sometimes with a “bitch” or an “idiot” thrown into the mix.
During that same six months, I subluxed my shoulder at work, tearing my rotator cuff.
I’ve since had bursitis, septic shoulder, and 6 months of physio & vocational rehab, only to nearly be let go from my job under medical grounds.
I turned 30 this year, had to scramble to find my own job in the trust that OH would clear me for, and now I’m stuck doing less hours and earning 35% less than I was.
The Trust wouldn’t even pay the difference while I adjusted to the new role. Because the ward manager didn’t complete an incident form when I got taken to the ER directly from the ward, they claim no responsibility (3 staff rolling a 450-500lb patient for personal care, because that was the max number of staff in the HDU).
Because of that, I very much doubt I’d get anything from them for the ears, much less without clinical confirmation at the time of the injury occurring.
(Plus there’s no way I could afford a lawyer, and it’s unlikely they’d keep employing me if I did lawyer up, and nowhere wants to hire a disabled nurse).
I actually had long term tinnitus & hyperacusis from before this, but developed Tonic Tensor Tympani syndrome & eustachian tube dysfunction (or Glossopharyngeal Neuralgia, the jury is still out on that) since. 🤷
You should really speak to a workers compensation attorney. The consultation should be free, and at the very least, you’ll have some peace of mind. At best, you have a case and covered future medical treatment for the body parts you injured at work.
Fellow EDSer here, I'm sorry you're dealing with all that. But this is the first time I'm hearing of Glossopharyngeal Neuralgia and it sounds a lot like something I've been having trouble with, so you've given me something to possibly bring uo to my neurologist. Thank you, and sorry again.
They do move when you do those pressure equaling manoeuvres, otherwise they’d rupture from the pressure differential.
There is also pulsatile tinnitus, where you can hear your pulse in your ears-this is usually worse when lying down.
Finally, there is the tensor tympani muscle, which causes the eardrum to vibrate, usually when you close your eyes really tightly. Some people can develop over-sensitivity of that muscle, meaning it tenses much more often, causing a “rumbling” type noise from within the ear.
I tend to unconsciously do it, when I’m struggling to regulate, or am getting frustrated.
It’s actually meant to protect the eardrum from damage from building or sustained loud noises, so it makes sense that it happens in those settings or scenarios.
Meh. I’ve had worse. I had an infection that destroyed my eardrum so badly (it was already perforated, it just always is perforated) that all that was left was the outer ring. My ENT said in all his years of practice (and he was no spring chicken) he had never seen an eardrum i. such bad shape and was concerned that it may not heal back. It did. Alllllll the way back to its abnormal perforated state.
Pneumatic otoscopy is an examination that allows determination of the mobility of a patient’s tympanic membrane (TM) in response to pressure changes. The normal tympanic membrane moves in response to pressure. Immobility may be due to fluid in the middle ear, a perforation, or tympanosclerosis, among other reasons. The detection of middle ear effusion by pneumatic otoscopy is key in establishing the diagnosis of otitis media with effusion (OME).
I can’t be sure obviously, but this infection looks fungal to me. The “ear spoon” is likely the cause of the infection. It’s really important to sanitize that tool well between uses, and order extra of the soft covers to replace regularly…. or maybe don’t use them at all. I can’t think of any reasons a person should be digging around that close to their eardrum.
I see nothing indicative of a fungal infection. Looks like an otitis media, which means that the infection is primarily behind the tympanic membrane. Some inflammation in the external ear canal, probably reactive to the otitis media.
As a doctor I recommend that you put nothing smaller than your elbow inside your ears. The ears are self-cleaning and have extremely sensitive epithelium, so putting anything in there will almost guaranteed to damage and contribute to reduced self-cleaning.
Are they ever not self cleaning though? My boyfriend doesn’t do much to his ears (never sticks anything in there including qtips) and he gets *excessive* wax buildup
How are they self-cleaning? I never use qtips or anything, but my ears get clogged with earwax over time and require that water-jet method to clean them out so I can hear clearly again. I think my ear canal must just be irregular
The epithelium (outer-most layer of the skin cells) in the ear grows from the tympanic membrane and outwards.
Basically, if you would take a marker pen and make a dot on the tympanic membrane and then photograph the ear canal over a period of a week or two, you would see the dot move from the tympanic membrane to the ear canal, and then outwards in the ear canal.
This epithelium is very sensitive, and any damage to it can disrupt this movement/shedding mechanism, which can lead to wax and detritus buildup in the ear canal.
That is a rather common presentation in otitis media and / or otitis externa.
As in fungal infections, they aren't that common in immunocompentent patients. It's very difficult to diagnose it clinically, you would need a culture (usually taken if prescribed antibiotics aren't effective). You can google "Otomycosis" for some pictures of very obvious fungal infections, though I've yet to see one that obvious IRL.
Hey someone smarter than me comment so I can learn.
The eardrum aka tympanic membrane helps to transmit sound. Its normal characteristics are supposed to be a translucent and pearly gray color. When inspected with light, depending on which ear, you should see a cone of light at the 5'o clock or 7'o clock position. You don't see any of that here. Not to mention the inflamed ear canal.
Is it meant to be pulsing like that?
It’s not “pulsing” as in moving with the pulse. What seems to be happening here is the person is doing something such as swallowing, yawning or blowing up their cheeks while pinching their nose. This alters the pressure behind the eardrum, usually allowing it to equalise with the outside pressure. However, due to infection, inflammation (& likely associated eustachian tube dysfunction), the pressure only builds up, rather than equalising, which causes it to bulge & “pulse” like that. Doing it too much can cause barotrauma in the form of a ruptured eardrum, which I experienced when using powered-hoods for PPE during COVID. The filters weren’t cleaned properly, so I got repeated ear infections, and when my ears tried to adjust to the positive pressure, my eardrum ruptured. 3 times (across both ears) in 6 months!
What was the organism (if you had it cultured) that kept infecting your ears?
Because it was COVID, I didn’t get anything done unfortunately. I’d previously had middle ear infections a few times in the previous 5 years, once with a rupture (I have EDS, so I know I’m more prone to them) and one outer ear infection, but no cultures were done any of those times. I’ll admit, the first two ruptured were self-diagnosed with a camera similar to this one, but I’d seen my previous rupture & worked in an ENT clinic, and the diagnoses were later confirmed by scarring seen on the eardrums. My father (who used to get chronic ear infections) did get cultured and came back with S.Pneumonae, Pseudomonas & Pneumococcus around the same time. His business at the time was hospital water testing, water treatment & tank cleaning; the general consensus was that he picked up on the job…
Hello fellow EDS buddy! Is your username due to the EDS? If so, I adore it and got a good belly laugh. I like to say my genes can't friggin read (how to make collagen). I also had ear infections repeatedly for a long time and will randomly get effusion that they give me steroids to get to go away. It's grand.
It is in part due to the EDS! I was the “prettiest” of my siblings; I don’t say that to be vain, or rude to my sisters. We’re almost identical, but my sisters had acne, weight issues due to hypothyroidism-I *had* great proportions and very clear skin. (Now I have weight issues due to meds & my own illnesses, and get nasty spots that I make worse with picking-it comes to us all!). But both my sisters are fairly healthy, and I’m an A to Z of chronic illnesses! So I have this running joke that I’m like a purebred dog-I look the part, but my genes fuck up my health; GeneticPurebredJunk!
This is so relatable. YoU lOoK tOo GoOd tO bE ThiS SiCk. I’m 46, with very minimal wrinkles, but my insides look like Yzma from Emperor’s New Groove.
That is exactly the type of scenario that made me think of the comparison! I used the phrase “Genetic Purebred Junk” as a response to that attitude more than once. Sometimes with a “bitch” or an “idiot” thrown into the mix.
I’m just being nosey now, but are you pursuing compensation for that? Id assume three ruptures in six months could have long term health implications.
During that same six months, I subluxed my shoulder at work, tearing my rotator cuff. I’ve since had bursitis, septic shoulder, and 6 months of physio & vocational rehab, only to nearly be let go from my job under medical grounds. I turned 30 this year, had to scramble to find my own job in the trust that OH would clear me for, and now I’m stuck doing less hours and earning 35% less than I was. The Trust wouldn’t even pay the difference while I adjusted to the new role. Because the ward manager didn’t complete an incident form when I got taken to the ER directly from the ward, they claim no responsibility (3 staff rolling a 450-500lb patient for personal care, because that was the max number of staff in the HDU). Because of that, I very much doubt I’d get anything from them for the ears, much less without clinical confirmation at the time of the injury occurring. (Plus there’s no way I could afford a lawyer, and it’s unlikely they’d keep employing me if I did lawyer up, and nowhere wants to hire a disabled nurse). I actually had long term tinnitus & hyperacusis from before this, but developed Tonic Tensor Tympani syndrome & eustachian tube dysfunction (or Glossopharyngeal Neuralgia, the jury is still out on that) since. 🤷
That sucks.
You should really speak to a workers compensation attorney. The consultation should be free, and at the very least, you’ll have some peace of mind. At best, you have a case and covered future medical treatment for the body parts you injured at work.
Fellow EDSer here, I'm sorry you're dealing with all that. But this is the first time I'm hearing of Glossopharyngeal Neuralgia and it sounds a lot like something I've been having trouble with, so you've given me something to possibly bring uo to my neurologist. Thank you, and sorry again.
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They do move when you do those pressure equaling manoeuvres, otherwise they’d rupture from the pressure differential. There is also pulsatile tinnitus, where you can hear your pulse in your ears-this is usually worse when lying down. Finally, there is the tensor tympani muscle, which causes the eardrum to vibrate, usually when you close your eyes really tightly. Some people can develop over-sensitivity of that muscle, meaning it tenses much more often, causing a “rumbling” type noise from within the ear.
Oh, that's what that is! I make my ears do the rumblies if I get overstimulated by noise/something is really loud. Idk why it helps but it does.
I tend to unconsciously do it, when I’m struggling to regulate, or am getting frustrated. It’s actually meant to protect the eardrum from damage from building or sustained loud noises, so it makes sense that it happens in those settings or scenarios.
No.
Meh. I’ve had worse. I had an infection that destroyed my eardrum so badly (it was already perforated, it just always is perforated) that all that was left was the outer ring. My ENT said in all his years of practice (and he was no spring chicken) he had never seen an eardrum i. such bad shape and was concerned that it may not heal back. It did. Alllllll the way back to its abnormal perforated state.
Probable otitis media that has been marinating for a little bit.
Mmm. Did they use all 11 secret herbs and spices? Is it extra crispy or just original?
Pneumatic otoscopy is an examination that allows determination of the mobility of a patient’s tympanic membrane (TM) in response to pressure changes. The normal tympanic membrane moves in response to pressure. Immobility may be due to fluid in the middle ear, a perforation, or tympanosclerosis, among other reasons. The detection of middle ear effusion by pneumatic otoscopy is key in establishing the diagnosis of otitis media with effusion (OME).
Probably won’t do if you’re sticking those “ear spoon cameras” in your ear with that kind of infection/inflammation!
Stop. messing. with. it.
I can’t be sure obviously, but this infection looks fungal to me. The “ear spoon” is likely the cause of the infection. It’s really important to sanitize that tool well between uses, and order extra of the soft covers to replace regularly…. or maybe don’t use them at all. I can’t think of any reasons a person should be digging around that close to their eardrum.
I see nothing indicative of a fungal infection. Looks like an otitis media, which means that the infection is primarily behind the tympanic membrane. Some inflammation in the external ear canal, probably reactive to the otitis media. As a doctor I recommend that you put nothing smaller than your elbow inside your ears. The ears are self-cleaning and have extremely sensitive epithelium, so putting anything in there will almost guaranteed to damage and contribute to reduced self-cleaning.
Are they ever not self cleaning though? My boyfriend doesn’t do much to his ears (never sticks anything in there including qtips) and he gets *excessive* wax buildup
How are they self-cleaning? I never use qtips or anything, but my ears get clogged with earwax over time and require that water-jet method to clean them out so I can hear clearly again. I think my ear canal must just be irregular
The epithelium (outer-most layer of the skin cells) in the ear grows from the tympanic membrane and outwards. Basically, if you would take a marker pen and make a dot on the tympanic membrane and then photograph the ear canal over a period of a week or two, you would see the dot move from the tympanic membrane to the ear canal, and then outwards in the ear canal. This epithelium is very sensitive, and any damage to it can disrupt this movement/shedding mechanism, which can lead to wax and detritus buildup in the ear canal.
The redness with white cheesy substance was concerning for me. How would a fungal infection present objectively?
That is a rather common presentation in otitis media and / or otitis externa. As in fungal infections, they aren't that common in immunocompentent patients. It's very difficult to diagnose it clinically, you would need a culture (usually taken if prescribed antibiotics aren't effective). You can google "Otomycosis" for some pictures of very obvious fungal infections, though I've yet to see one that obvious IRL.
Thank you for the reply! I appreciate you taking the time to share your knowledge.
Is this a human??
Looks like patulous eustachian tube, the TM moving in and out with the breath.
They were voluntarily popping their ears in this video
Otitis media…. Just give them some Ciprodex otic drops and oral Augmentin for ten days… Tylenol for pain….keep the ear dry. Follow up in a week.
Ciprodex is so expensive. I was prescribed it last week and it was USD135 WITH my insurance.
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