Ruptured Tympanic Membrane

Discussion in 'DoDMERB' started by USMA08Mom, Jul 27, 2006.

  1. USMA08Mom

    USMA08Mom Member

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    My son had his initial DoDMERB physical at Fort Gordon today. He had chronic otitis media as a small child, but no episodes since 1995. He had vent tubes placed in 1989 and 1994. I was aware that he had scarring on the tympanic membrane on the left, but was told today that there is a question of whether there is a hole. (Direct quote in notes on DD form 2351 "Deformed Lt T.M. with large white scar posterior. It is questionable whether Lt T.M. is intact. Hearing normal"). My son swears that ear "pops" like his other one. I am anticipating a visit to an ENT when the inevitable "more info needed" comes. How big a problem are we looking at if it is not intact? He is applying for USMA (1st choice), USNA, and ROTC Scholarship.
     
  2. RetNavyHM

    RetNavyHM USN (RET)

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    USMA08Mom,

    I can almost guarentee that DoDMERB will request an ENT evaluation for your son. If there is no perforation then there is no problem. If the tympanic membrane is ruptured that would be a disqualification. In my experience that disqualification is very rarely waivered for the sea services, I'm not sure about the other services. If it is ruptured there is a procedure that can be done (tympanoplasty). That is a different disqualification, but it is only for 120 days, provided he heals and the procedure is something the ENT would have to agree to.

    My suggestion would be to have your son evaluated by your family physician, and if he/she states there is no perforation I would get a copy of that report and mail it to DoDMERB right away, even if they haven't seen his physical exam. This way that information will be in the system, and you may not have to see an ENT. Once DoDMERB requests the specialists evaluation they will not accept anything else and the family physician is the cheaper and easier option.

    Hope this helps!
     
  3. USMA08Mom

    USMA08Mom Member

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    Thanks!

    I already made a ENT appointment for Tuesday afternoon. Hopefully that will settle it. If not, should I speak to the doctor about a tympanoplasty ASAP? (I understand that there may be reluctance on his part since there is no pain/recent history of infection). It is so wonderful to have someone knowledgeable to ask questions -- as someone who navigated DoDMERB three years ago with my first son, I really appreciate your help!
     
  4. BR2011

    BR2011 USAFA Cadet

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    I'm having one of those on monday :thumbdown: (tympanoplasty). if he does indeed need this done, make sure to find a doctor who is proficient at it and performs them often. this will be my second one (along with 2 failed paper patches). According to the doctor who will perform it, the previous surgery was done sloppily and incorrect.

    I hope it all works out for him:thumb:
     
  5. RetNavyHM

    RetNavyHM USN (RET)

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    I agree with what BR2011 says. The tympanoplasty can have problems attaching, and if your son needs the procedure done, make sure that you are dealing with an ENT physician who is knowledgeable and has done the procedure before. If the ENT does not want to do the tympanoplasty for the reasons that you mentioned, let the ENT know that if he does have a tympanic membrane perforation he will be found medically disqualified for all military services, and the chances of a waiver are not very high. If he does get a waiver for the perforation, he will never become a diver, flyer, special forces or submariner. If he/she is still reluctant to do it, ask your family physician if he/she knows any other ENT physicians. In my experience I've found that if the specialist is aware of what your son is trying to do, and knows the limitations of inaction, they will be more than happy to help.
     
  6. USMA08Mom

    USMA08Mom Member

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    Rupture confirmed -- what now?

    Had appointment with ENT this afternoon and confirmed hole in tympanic membrane. Small (about 2mm) and he feels confident he can repair it. The Dr. was familiar with being disqualified by the hole, and assured my son he has successfully helped others become qualified by performing the tympanoplasty. Told us the surgery has 90% success rate. We are waiting for insurance to apporve procdure, and will schedule ASAP. Should I contact DODMERB to let them know, or just wait for them to contact us with the remedial request (physical was done at Ft. Gordon on 7/27/06)?
     
  7. RetNavyHM

    RetNavyHM USN (RET)

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    USMA08Mom,

    If you have the report from the physician I would go ahead and mail it in to DoDMERB. Ensure that the report states he will be having the tympanoplasty done and include a letter from your son stating that the tympanoplasty will be completed as soon as possible. The disqualification initially may be for the perforated tympanic membrane, but once the tympanoplasty procedure is done, get a copy of the operative report and again, have your son write a letter requesting that the disqualification for the perforation be removed. The perforation disqualification should be removed and a new disqualification added for the tympanoplasty added. Make sure that you forward records from all his follow up appointments to DoDMERB as they automatically get forwarded to the waiver authorities.

    The tympanoplasty disqualification is time limited, 120 days, and it is up to your son to request that the disqualification be removed at the end of the 120 days. I would have your son examined at the 120 day mark, and if everything is normal, send in a copy of that exam with a request to have the disqualification removed.

    I know this is a lot of work, but the ball is in your son's court. DoDMERB deals with to many people to be able to keep track of when a particular disqualification should be removed. It is also possible that a wavier may be granted before the 120 mark. If that happens it is completely up to you whether to get the disqualification removed or not. There is no negative connotation to a wavier at all. It will in no way affect his career in the future.

    Best of luck, and I hope all goes well. If there is anything else I can help with please let me know!
     

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