Ruptured Eardrum (Acutely Perforated Tympanic Membrane)

What is a ruptured eardrum?

Your eardrum is a flexible membrane that separates your outer ear from your middle ear. You can rupture your eardrum if you have a severe middle ear infection or you injure or damage your eardrum. A ruptured eardrum may affect your hearing and sense of balance. Ruptured eardrums often heal without treatment. Sometimes, however, you may need surgery to repair your damaged eardrum. Protecting your ears is the best way to prevent ruptured eardrums.

How does a ruptured eardrum affect my body?

Your eardrum is one of many working parts in your hearing system. Your outer ear collects sounds that make your eardrum vibrate. Those vibrations create a signal for your auditory nerve that the nerve sends to your brain. Your brain translates those signals into sound. When you rupture your eardrum, it’s as if there’s a short circuit in your hearing system because your eardrum can’t transmit sound effectively.

Your eardrum also protects your middle ear from foreign substances like water, bacteria and debris like skin cells. A ruptured eardrum is an easy target for bacteria that cause ear infections (otitis media).

Sometimes, skin cells and other debris pass into your middle ear, forming a middle ear cyst (cholesteatoma). These cysts have proteins that may damage your middle ear bones. Middle ear cysts also increase your risk of developing middle ear infections.

Is a ruptured eardrum serious?

In some instances, a ruptured eardrum maybe a serious health issue if the hole or tear in your ear doesn’t heal on its own. For example, a ruptured eardrum can cause the following:

• Long-term hearing loss.
• Long-term vertigo.
• Long-term dizziness.
• Infection that can spread in your ear.
• Persistent ear drum perforation (hole).

What are common ruptured eardrum symptoms?

Unless something hit your ear, you may not realize you have a ruptured eardrum until you have symptoms like changes in your hearing or blood and pus draining from your ear. Common ruptured eardrum symptoms include:

• Sudden hearing loss. You may have trouble hearing or feel as if sounds are muffled.
• Sudden sharp pain in your ear.
• Drainage from your ear that may look like pus or blood.
• Tinnitus. This is a buzzing or ringing noise in your ear that comes from inside your ears.

What does a ruptured eardrum feel like?

A ruptured eardrum may feel like a sudden sharp pain in your ear. This usually happens if your eardrum is torn or punctured by a sharp object or because something hit your ear very hard.

What causes ruptured eardrum drainage?

Eardrum drainage may happen if you have a middle ear infection. Pus from your infection may flow through the rupture.

What causes a ruptured eardrum?

Middle ear infections are the most common reason for ruptured eardrums. Other ways you may develop a ruptured eardrum include:

• Foreign objects: You can rupture your eardrum by using cotton swabs or other small pointed objects to clean your ears or scratch an itch in your ear. You may also rupture your eardrum by accident, such as being hit in the ear by a thrown pencil or running into a low-hanging twig.
• Trauma: Someone hits your ear with an open-handed slap or hits your ear or the side of your head very hard.
• Barotrauma: You may develop ear barotrauma if your Eustachian tube is blocked or irritated. When that happens, air is trapped between your eardrum and your middle ear, increasing the chance your eardrum may rupture when there’s a change in air pressure.
• Sudden explosive sounds: Your eardrums may rupture if you’re close by when there’s an explosion or guns are fired.

How do healthcare providers diagnose ruptured eardrums?

Healthcare providers typically examine your inner ear with an otoscope. An otoscope is a lighted instrument that helps healthcare providers look at your eardrum. Hearing specialists called audiologists may also do hearing tests to measure your hearing and eardrum motility. Tests may include:

• Audiometry/audiogram: These terms refer to hearing tests. Audiometry tests your ability to hear soft sounds and different pitches. Audiograms are charts that illustrate audiometry results.
• Tympanometry: This test checks eardrum movement.

Will a ruptured eardrum heal itself?

Ruptured eardrums often heal on their own. When they don’t, people should talk to an ear, nose and throat specialist (ENT) about additional treatment. Treatments may include:

• Myringoplasty: Your ENT places a medicated paper patch over the tear or hole in your eardrum. Eventually, your eardrum grows back, filling in the tear or hole.
• Tympanoplasty: This surgery involves taking skin, cartilage or material from another area of your body to patch the tear or hole in your eardrum.

How do I prevent rupturing my eardrum?

Protecting your ears goes a long way toward preventing a ruptured eardrum. Ways to protect your ears and eardrum include:

• Getting treatment for middle ear infections: Middle ear infection symptoms include earache, nasal congestion, fever and trouble hearing. Contact a healthcare provider if your symptoms last for more than a few days.
• Cleaning with care: Don’t use cotton swabs or other objects to clean your ears — it’s easy to rupture an eardrum, even with a cotton swab. Instead, gently wipe the outside of your ear with a clean finger or the end of a clean cloth.
• Avoiding airplane ear: Airplane ear is barotrauma. Barotrauma feels as if someone has stuffed your head with cotton. You may develop airplane ear while flying in an airplane. Sudden altitude changes when planes take off and land may affect your ears. You may be able to avoid airplane ear by yawning, chewing gum or wearing special earplugs that neutralize air pressure changes.
• Protecting your ears from explosive noise: You may rupture your eardrum if you’re close to explosive noises like firing guns or explosives going off. Wear earplugs or other ear protection any time you think you could be exposed to explosive noise.

How long does it take a ruptured eardrum to heal?

Your ruptured eardrum may need several months of healing time. Contact your healthcare provider if you’re still having symptoms like pain, drainage or hearing issues. You may need additional treatment.

How do I take care of myself while my ruptured eardrum heals?

The most important step is to protect your ruptured eardrum. You may do that by:

• Keeping your eardrum dry: Use waterproof earplugs or cotton balls coated with petroleum jelly when you shower or take a bath. If you swim for exercise, please find another way to keep moving. Moisture in your ear from swimming may affect your eardrum.
• Don’t clean your ears: Even gentle cleaning may keep your eardrum from healing.
• Avoid blowing your nose: If possible, don’t blow your nose while your eardrum is healing. If you have allergies, ask your healthcare provider about ways to prevent a stuffy nose.

When should I see a healthcare provider for a ruptured eardrum?

If you know you have a ruptured eardrum, contact a healthcare provider if your symptoms don’t go away within a few weeks.

When should I go to the emergency room if I have a ruptured eardrum?

You should go to the emergency room if you think you may have damaged your eardrum due to a foreign object in your ear.

What questions should I ask a healthcare provider?

If you think you have ruptured eardrum, here are some questions you may want to ask a healthcare provider:

• Do I have a ruptured eardrum?
• If I have a ruptured eardrum, what can you do to treat it?
• What should I do to protect my eardrum as it heals?
• At what point do we need to consider other treatments?

A note from Cleveland Clinic

Your eardrum is a fragile instrument. It’s also an essential instrument. A ruptured eardrum may affect your hearing and balance. It may also increase your risk of ear infections because your damaged eardrum can’t protect your middle ear from invading bacteria. That’s why it’s important to protect your eardrum. Ruptured eardrums typically heal on their own, but it takes time for them to heal. If you have a ruptured eardrum that isn’t healing, be sure to let your healthcare provider know. You may need surgery.