How to disclose pin hole perforation in a discharging ear through valsal...

https://youtu.be/Q_Nqsc8i-LI

A person presents to you with a discharging ear but on otoscopic examination, No perforation is found despite meticulous suction cleaning. In such cases, applying Valsalva Maneuver (Forced expiration against closed Nose and mouth helps to pop middle ear with air), helps to disclose very tiny perforation ( like a pin hole). This technique is useful as this help us to distinguish Outer ear infection from middle ear infection and changes the whole scenario in diagnosis. Even in normal cases, seeing the ear drum moving outward in response to Valsalva maneuver help to establish normal Eustachian tube function Eustachian tube connects back of the nose to middle ear and that's how it equilibrizes middle ear pressure with atmospheric pressure. sometimes infection in middle ear lead to high pressure. Pus formation under pressure needs and outlet to come out of ear. This pus make very tiny temporary perforation which comes out only when middle ear pressure is high that typically happens during mid night. This tiny perforation or pin hole perforation closes as soon as pressure in middle down comes down. ENT Surgeon is in dilemna to distinguish between suppurative middle ear infection or Otomycosis of outer ear canal alone though both conditions may exist. If there is no middle ear infection, then treatment is lot easier and can only be managed with ear drops only. Middle ear infection means antibiotics and nose opening drops have to be continued for long. #Pinholeperforation #discharging ear #CSOM #ASOM #Valsalva Maneuvre #Suppurative otitis media Dr Ajay Jain, MS (PGI Chd), DNB ENT and Head & Neck Surgery ENT Clinic: Shop No:1,2,3 DDA Market-1, G-block, Preet Vihar, Delhi-92. Landmark: Enter G-block opposite Metro pillar 102 Appointments: 9871166370. Website: www.drajayjain.com Map: Https://goo.gl/maps/6x1Q1qBEJ6v Other Videos Care of discharging ears (CSOM)-बहते हुए कानों की देखभाल https://youtu.be/skst8yH-kkU Must see video before ear surgery -कान के ऑपरेशन से पहले कम से कम एक बार इस वीडियो को देखें https://youtu.be/dmT1-hrL2XQ