Which measure is recommended after tympanic membrane perforation?

• A. Avoid water/moisture/topical aminoglycosides
• B. Most perforated tympanic membranes heal spontaneously
• C. Follow-up is unnecessary
• D. Use of broad-spectrum antibiotics is mandatory

Answer: (A)

Protecting the healing tympanic membrane from infection and toxicity is the priority after a perforation. Water exposure increases the risk of infection in the ear canal and middle ear through the perforation, which can impede healing. Topical aminoglycosides are avoided because they can be ototoxic when the tympanic membrane is not intact, potentially harming hearing or balance. If antibiotics are needed, non-ototoxic options (such as fluoroquinolone drops) are preferred. Most perforations heal spontaneously with proper protection, and follow-up helps ensure healing and catch complications early.