Because of the progressive muscle weakness they experience, patients with Duchenne muscular dystrophy frequently utilize positive-pressure devices to maintain adequate bronchial hygiene and ventilation. This case illustrates the course of a 19-y-old male who presented with a perforated right tympanic membrane (TM) following the use of these devices. Perforation of the TM while utilizing positive-pressure devices is a rarely reported event. A challenging aspect in this case was balancing the reduction of pressures and maintaining adequate ventilation while at the same time allowing the TM to heal.
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