Ruptured Eardrum (Acutely Perforated Tympanic Membrane)

Overview

What is a ruptured eardrum?

A ruptured eardrum is a hole or tear in the skin-like tissue that separates the ear canal and middle ear. The eardrum is the part of the ear that receives vibrations from sound to allow hearing. Ruptured eardrums are most common in children.

Symptoms and Causes

What are the symptoms of a ruptured eardrum?

A ruptured eardrum is often caused by a middle ear infection. With an infection fluid develops behind the drum creating pain and discomfort. This fluid buildup can create a small rupture of the drum allowing fluid to drain from the ear, appearing as pus. Bleeding may also occur. The ruptured eardrum may also cause temporary hearing loss as a result of the hole in the drum and the drainage.

What are the causes of a ruptured eardrum?

  • Ear infection within the middle ear (acute otitis media)
  • Injury to the side of the head as a result of a sudden and forceful strike to the head
  • Sticking objects in the ear that travel too far down in the ear canal and can puncture the eardrum, such as a cotton swab or bobby pin
  • Sudden change in air pressure
  • Skull fracture
  • Loud noise caused by an explosion

Diagnosis and Tests

How is a ruptured eardrum diagnosed?

An ENT (ear, nose and throat specialist) may identify holes or tears in the eardrum by using various methods:

  • Otoscope (auriscope): A lighted instrument used to view the ear canal
  • Audiology exam: A test that measures hearing and eardrum mobility

Management and Treatment

How is a ruptured eardrum treated?

Ear drops or oral medication (antibiotics) may be prescribed. In most cases, healing of the eardrum occurs spontaneously within two months. Usually, hearing loss (if any) lasts a short time. Some rare complications of a ruptured eardrum include:

It is typically more comfortable to keep the ear dry while showering and one should avoid swimming until after examined. When blowing your nose, do not be too forceful because the pressure can create pain and discomfort in your ears.

If an eardrum does not heal after two months of observation, an ear, nose, and throat specialist may perform a simple repair called a myringoplasty to help aid the healing process. This procedure is used to repair small tears in an eardrum and consists of a small patch placed in or on the hole. If the tear does not heal properly or is taking too long to heal, a surgery known as a tympanoplasty may be required. Tympanoplasty is a more formal procedure that repairs a damaged ear drum.

Prevention

How can I prevent a ruptured eardrum?

  • Protect your ears by wearing ear plugs when around loud noises.
  • Do not stick objects into the ear canal that could possibly puncture the eardrum.
  • Let your doctor know right away if you feel pain or experience symptoms of an ear infection.

Last reviewed by a Cleveland Clinic medical professional on 04/18/2019.

References

  • American College of Otolaryngology. Perforated Eardrum (http://www.entnet.org/HealthInformation/perforatedEardrum.cfm) Accessed 4/30/2019.
  • Merck Manual. Eardrum Perforation. (https://www.merckmanuals.com/home/ear,-nose,-and-throat-disorders/middle-ear-disorders/eardrum-perforation) Accessed 4/30/2019.
  • National Health Service. Perforated Eardrum. (https://www.nhs.uk/conditions/perforated-eardrum/) Accessed 4/30/2019.

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