Retracted Eardrum

What is a retracted eardrum?

A retracted eardrum is when an air imbalance pulls or sucks in your tympanic membrane (eardrum) toward the middle of your ear. This happens when the air pressure inside of your ear and outside of your ear isn’t equal. Certain conditions, like eustachian tube dysfunction, can cause it.

Typically, your eardrum is cone-shaped, and the center of it dips slightly inward toward your middle ear. A retracted eardrum dips even farther toward your middle ear, so the dip is more pronounced.

A healthcare provider can look inside your ear with an otoscope and easily tell if you have a retracted eardrum. An otoscope is a handheld device with a light and magnification. This allows your provider to see your eardrum clearly.

How serious is a retracted eardrum?

Retracted eardrums can range from mild to severe. Some get better on their own, and some need treatment. It’s important to visit a healthcare provider if you think you might have a retracted eardrum. In some cases, it can lead to conditions like ear infections and temporary or permanent hearing loss.

What does a retracted eardrum feel like?

Sometimes, retracted eardrums don’t cause any symptoms. But if your eardrum pulls back enough to press on the tiny bones in your middle ear (ossicles), then you could develop retracted eardrum symptoms like:

• Earache.
• A feeling of fullness or pressure in your ear.
• Ear drainage (otorrhea).
• Temporary hearing loss.
• Permanent hearing loss (less common).

What causes a retracted eardrum?

The outside air pressure should remain equal to the air pressure inside your ears. A disruption in this balance (for instance, rapid changes in air pressure) can cause a vacuum effect that pulls your eardrum toward your middle ear.

Eustachian tube dysfunction is the most common cause of a retracted eardrum. This condition causes blockage in the tubes that connect your middle ears to your upper throat. Related conditions include:

• Ear infections.
• Upper respiratory infections.
• Sinus infections (sinusitis).
• Chronic allergies.
• Enlarged tonsils or adenoids.
• Ruptured eardrum.

Retracted eardrum complications

Sometimes, retracted eardrums get better on their own. But in some cases, the condition can cause cholesteatoma (a noncancerous, cyst-like growth behind your eardrum). Cholesteatoma may result in damage to your ossicles — the three tiny bones in your middle ear (malleus, incus and stapes) that transmit sound waves to your inner ear. Left untreated, this can result in hearing loss.

How do healthcare providers diagnose retracted eardrums?

An otolaryngologist (ENT) will examine your ears. They’ll also ask about your symptoms and whether you’ve had chronic ear conditions (like infections) in the past.

Stages of eardrum retraction

Healthcare providers use a staging system to describe the severity of retracted eardrums:

• Stage 1: Your eardrum retracts but doesn’t touch your ossicles (the tiny, sound-conducting bones in your middle ear).
• Stage 2: Your eardrum retracts and touches your ossicles.
• Stage 3: Your middle ear cavity begins to narrow due to your retracted eardrum.
• Stage 4: Chronic inflammation causes your retracted eardrum to get stuck in your middle ear.

How do healthcare providers treat retracted eardrums?

Some retracted eardrums don’t require treatment. Your healthcare provider may recommend monitoring your condition until the pressure inside of your ears returns to normal. This may take a while — up to several months. During this time, your provider will keep a close eye on your symptoms. They may also recommend trying the Valsalva maneuver — an exercise you can do at home to normalize the pressure in your ears.

If you have a severely retracted eardrum, you may need treatment. The goal of retracted eardrum treatment is to stabilize the air pressure inside of your ears. There are several ways to do this. Possible treatments include:

• Medications.
• Retracted eardrum surgery.

Medications

Healthcare providers use a range of medications to treat retracted eardrums, including:

• Nasal decongestants to ease congestion and stuffiness.
• Steroids to reduce inflammation.
• Antibiotics to treat infection.

Retracted eardrum surgery

If a retracted eardrum presses on your ossicles or interferes with your hearing, your provider may recommend surgery. Common surgical treatments include:

• Ear tubes (tympanostomy): An otolaryngologist places tubes in your eardrum during a procedure called myringoplasty. This helps equalize the pressure within your middle ear. (You’ll still need to treat any underlying causes of eustachian tube dysfunction. For example, if swollen tonsils are a contributing factor, your provider may recommend a tonsillectomy.)
• Tympanoplasty: If retraction causes your eardrum to rupture (tear), an otolaryngologist can repair the hole with tympanoplasty.

Can I prevent retracted eardrums?

In most cases, you can’t prevent a retracted tympanic membrane. Developing the condition is usually out of your control.

You might be able to reduce your risk for barotrauma-related retraction by wearing earplugs or taking a decongestant before you fly on a plane.

What can I expect if I have a retracted eardrum?

Mild ear retraction may not require treatment. In these cases, your provider may take a “wait and see” approach. But if your retracted eardrum is severe or doesn’t get better in a few months, you may need surgery.

How long does a retracted eardrum last?

It varies for everyone. Some people notice an improvement in just a week or two. Others may have lingering symptoms for a few months.

If your symptoms don’t go away on their own within six months, your healthcare provider will likely recommend treatment.

Outlook for retracted eardrums

Mildly retracted eardrums often repair themselves over time. More severe cases may require treatment. However, the overall outlook is good if you get treatment in a timely manner.

When should I see my healthcare provider?

Schedule an appointment with your healthcare provider if you have symptoms that don’t go away within one week, including:

• An earache.
• A feeling of fullness in your ear.
• Fluid draining from your ear.
• Muffled hearing.

Will a retracted eardrum fix itself?

It’s possible. If you have a mildly retracted eardrum, it could fix itself over time. Your healthcare provider will still want to monitor your condition to make sure it doesn’t get worse.

Severely retracted eardrums usually need treatment. This may include medication (like steroids or decongestants) or surgery.

Can you fly with a retracted eardrum?

Flying with a retracted eardrum, ruptured eardrum or eustachian tube dysfunction increases your risk for middle ear and inner ear damage. If you need to fly, be sure to talk to your healthcare provider first.

A note from Cleveland Clinic

Retracted eardrums — when an air imbalance pulls your eardrum inward, toward your middle ear — can range from mild to severe. Some people have little to no symptoms, while others develop earaches, drainage or even hearing loss. If you notice that your ears don’t feel quite right, it’s important to tell your healthcare provider. Even if you don’t need treatment, they can confirm your diagnosis and monitor your progress until you recover.