Ruptured Eardrum

A ruptured eardrum (also known as a perforated eardrum) is a hole or tear in the thin tissue that separates your outer ear from your middle ear. It can happen because of a bad ear infection or an injury to your ear.

A ruptured eardrum can affect your hearing or sense of balance. But in many cases, it heals on its own. Sometimes, you may need surgery to fix it. The best way to prevent it is to protect your ears from injury and infection.

If you think you’ve ruptured your eardrum, don’t panic — but don’t ignore it, either. Most tears heal with time, but some may need treatment.

Ruptured eardrum symptoms

You might not know your eardrum is ruptured right away, especially if nothing hit your ear. Many people notice changes in hearing or drainage from their ear as the first signs.

Common symptoms include:

• Ear pain: This pain can come on suddenly and may go away quickly.
• Fluid draining from your ear: It may look like pus or have blood in it.
• Sudden hearing loss: Sounds may seem muffled or harder to hear.
• Tinnitus: This is a ringing, buzzing or humming sound in your ear that doesn’t come from outside.

If you notice any of these symptoms, it’s a good idea to get checked out. A ruptured eardrum usually heals on its own, but it’s best to let a provider confirm what’s going on.

Ruptured eardrum causes

The most common cause of a perforated eardrum is a middle ear infection. When fluid builds up behind your eardrum, it creates pressure that can make it tear or pop.

Other common causes include:

• Ear injuries or trauma: A hard hit to your ear or head, like from a fall or a slap, can rupture your eardrum.
• Loud, explosive sounds: Your eardrums may rupture if you’re close by when there’s an explosion or gunfire.
• Pressure changes (barotrauma): If air gets trapped in your middle ear during flying or diving, a sudden change in pressure can make your eardrum burst.
• Sticking objects in your ears: Using cotton swabs or other small objects to clean or scratch your ear can puncture your eardrum. Even accidents, like bumping into a twig or getting hit by a thrown object, can cause damage.

How to lower your risk

Protecting your ears is the best way to prevent a ruptured eardrum. Here are a few simple tips:

• Clean with care: Skip cotton swabs. Use a clean cloth to gently wipe the outside of your ear.
• Prevent airplane ear: Flying can cause pressure changes that affect your ears. Chew gum, yawn, or wear special earplugs during takeoff and landing.
• Protect your ears from loud blasts: Gunfire or explosions can rupture your eardrum. Use earplugs or hearing protection if you’ll be near loud or explosive noise.
• Treat ear infections early: Signs of a middle ear infection include ear pain, stuffy nose, fever or trouble hearing. See a provider if symptoms last more than a few days.

Complications of this condition

A ruptured eardrum is sometimes a serious issue, especially if it doesn’t heal on its own. Possible long-term complications include:

• A hole that doesn’t close
• Dizziness or balance problems
• Ongoing hearing loss
• Repeat ear infections
• Skin growth that can damage your middle ear (cholesteatoma)

Your eardrum also acts as a barrier. When it’s torn, germs, water and debris can enter more easily and raise your risk of infection.

How doctors diagnose eardrum rupture

To check for a ruptured eardrum, your provider will look inside your ear with a tool called an otoscope. It shines a light into your ear so they can see your eardrum clearly.

You might also have hearing tests. These help measure how well your eardrum is working and how well you hear.

Common tests include:

• Audiometry (audiogram): Checks how well you hear soft sounds and different tones
• Tympanometry: Shows how well your eardrum moves

These tests help your provider figure out if you have an eardrum rupture or another ear issue.

How is a ruptured eardrum treated?

In many cases, a ruptured eardrum heals on its own without treatment. But if it doesn’t, you may need to see an ear, nose and throat specialist (ENT) for help.

Treatment options may include:

• Myringoplasty: Your ENT places a small paper patch over the hole. The patch helps your eardrum grow back and close the tear.
• Tympanoplasty: This surgery uses tissue from another part of your body (like skin or cartilage) to repair the eardrum.

Recovery time

Most ruptured eardrums heal within a few weeks, but some may take a few months. Contact your healthcare provider if you still have pain, drainage or hearing problems. You might need more treatment.

When should I see my healthcare provider?

Call your provider if your symptoms don’t improve within a few weeks, or if they get worse.

Go to the emergency room if:

• Something is stuck in your ear
• You have sudden, severe ear pain or hearing loss
• You think a sharp object damaged your ear

What can I expect if I have this condition?

Most ruptured eardrums heal on their own, but how you care for your ear can make a big difference. Here’s how to protect your ear while it heals:

• 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.
• Don’t clean your ears: Even gentle cleaning may keep your eardrum from healing.
• Keep your ear 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.

What side should I sleep on with a ruptured eardrum?

If you have a ruptured eardrum, try sleeping on the side that doesn’t hurt or doesn’t have fluid coming out. This keeps pressure off the damaged ear.