Hearing aids worn with tympanic membrane perforation: complications and solutions.

Hearing aids are sometimes recommended in ears with tympanic membrane perforation. Presented are six illustrative cases that represent various degrees of perforation, ear-mold styles, and wearing habits. The degrees of perforation represented include total, 50%, 20%, myringotomy tube, and modified mastoid cavity (canal up). Patients wearing earmolds with total perforation experience nearly constant irritation, infection, itching, or drainage. Rare periods of success are achieved in such cases by strict adherence to hygiene and ventilation guidelines. Lesser degrees of perforation usually experience significantly fewer problems if such guidelines are followed. Ear ventilation is found to be the primary success factor, whether achieved by periods of non-use or earmold venting. Since the potential for serious complications always exists, such fittings require patient education and regular otologic follow-up.