Ruptured Eardrum (Perforated Eardrum)
Our eardrum, or tympanic membrane, is a thin tissue separating the ear canal and the middle ear. It is a vital organ for hearing. It also acts as a protective barrier preventing water, germs, or foreign substance from entering the middle ear. When the eardrum ruptures, a tear or hole in the tympanic membrane occur, increasing the risk of hearing loss and infections. Frequently, a perforated or ruptured eardrum can heal by itself. Severe cases will require a surgical repair.
Symptoms
- Pain in the ear
- Ear discharge
- Tinnitus
- Vertigo, nausea, and vomiting
- Hearing loss
When to see a doctor
If you experience the above symptoms, make a doctor’s appointment to check if you have a ruptured eardrum.
Causes
- Putting objects such as a cotton swab into your ear can cause a puncture in the eardrum.
- Acoustic trauma from a gunshot or an explosion can tear the eardrum.
- Otitis media or middle ear infection from the accumulation of fluids in the middle ear.
- Barotrauma from diving, for instance.
- Severe head injury such as a skull base fracture
Complications
- Hearing loss can occur temporarily until the tear heals. The degree of hearing loss depends on the size and location of the perforated eardrum.
- Otitis media or bacterial infection in the middle ear. Some people may experience recurrent or chronic middle ear infections, leading to hearing loss.
- Cholesteatoma is a rare abnormal collection of ectoderm cells in the middle ear.
Prevention
- Avoid putting foreign objects into your ear. Objects such as a cotton swab or paper clip can puncture the eardrum. If required, clean the external area of the ears with a damp washcloth.
- Seek medical care if you develop fever, earache, and reduced hearing because these are signs of middle ear infections, which can cause damage to the eardrum.
- When traveling by plane, protect your ears with pressure-equalizing earplugs, chewing gum, or frequent yawning. Use the Valsalva maneuver by pinching your nose and closing your mouth while exhaling forcefully as if you are blowing your nose.
- Wear protective earmuffs or earplugs if your work involves exposure to high intensity noises, i.e., at a construction site.
Diagnosis
- History taking and physical examination with an otoscope or microscope.
- Laboratory tests to check if there is a middle ear infection.
- Tuning fork evaluation to determine hearing loss
- Tympanometry to identify the response of the eardrum.
- Audiology exam to measure the ability to differentiate sounds at different volumes, pitches, and frequencies.
Treatment
Usually, a tear or hole in the eardrum can heal by itself within a couple of weeks. If there is an infection, your doctor may prescribe antibiotic drops. If the perforated eardrum does not resolve, your doctor may recommend the following treatments.
- Eardrum patch: A medicated paper will be applied to seal the hole. The doctor may repeat this treatment several times before the tear heals and closes.
- Tympanoplasty: The patient’s own tissue will be grafted to the eardrum to close the hole, which can be an outpatient procedure.
Home remedies
- Refrain from blowing the nose when you have a perforated eardrum.
- Avoid cleaning your ear canals as it may impede the healing process.
- Keep your ear dry. Cover your ear with a shower cap or silicone earplugs when taking a shower.
Preparing for your appointment
- Make a list of your symptoms, including those that may not be related to ear or hearing loss.
- Write down if you have had ear infections, injuries, or recent air travel.
- List the medications and dietary supplements you are taking.
Questions you may want to ask your doctor:
- What are the causes of my symptoms?
- What can I do to speed up the healing?
- What kind of treatments are available?
Questions that your doctor may ask you:
- When is the onset of the symptoms?
- Have you tried to clean or put anything in your ears?
- Have you ever had ear pain, infection, vertigo, or head injuries?
- Are you often exposed to loud noises?
- Recent swimming, diving, or flying?
While waiting for your doctor’s appointment, keep your ears dry and do not use over-the-counter ear drops.
