You are on page 1of 15

1.

A ruptured eardrum, like a clap of thunder, can happen suddenly. You may feel a sharp pain in your
ear, or an earache that you've had for a while suddenly goes away. It's also possible that you may
not have any sign that your eardrum has ruptured.
A ruptured eardrum -- also known as a perforated eardrum or a tympanic membrane perforation -can lead to complications such as middle ear infections and hearing loss. It may also require surgery
to repair the damage to the eardrum. But typically, especially if you protect your ear, a ruptured
eardrum will heal on its own without treatment within a couple of months.

What Is a Ruptured Eardrum?
A ruptured eardrum is a tear in the thin membrane that separates your outer ear from your inner ear.
That membrane, known as the tympanic membrane, is made of tissue that resembles skin.

The eardrum serves two important functions in your ear. It senses vibrating sound
waves and converts the vibration into nerve impulses that convey the sound to
your brain. It also protects the middle ear from bacteria as well as water and foreign
objects. Normally, the middle ear is sterile. But when the eardrum is ruptured, bacteria
can get into the middle ear and cause an infection known as otitis media.

What Causes a Ruptured Eardrum?
A number of things can cause the eardrum to rupture; one of the most common causes
is an ear infection. When the middle ear is infected, pressure builds up and pushes
against the eardrum. When the pressure gets too great, it can cause the eardrum to
perforate. When that happens, you may suddenly notice that the pain and pressure
you've felt from the infection suddenly stops and pus drains from the ear.
Another common cause of a ruptured eardrum is poking the eardrum with a foreign
object, such as a cotton-tipped swab or a bobby pin that's being used to clean wax out
of the ear canal. Sometimes children can puncture their own eardrum by putting objects
such as a stick or a small toy in their ear.
Some ruptured eardrums result from what's known as barotrauma. This happens when
the pressure inside the ear and the pressure outside the ear are not equal. That can
happen, for example, when an airplane changes altitude, causing the air pressure in the
cabin to drop or rise. The change in pressure is also a common problem for scuba
divers.

The doctor may also ask for an audiology test. which uses a series of tones you listen to with . if there is a hole or tear in the eardrum. the doctor may clean the ear canal or prescribe eardrops for you to use to help clear it. Sometimes there may be too much wax or drainage for the doctor to clearly see the eardrum. air will rush out. the doctor will do an otoscopic exam. Others see their doctor only after several days of general discomfort in their ear and feeling that "something's not quite right with the ear. Other symptoms of a ruptured eardrum include:       Sudden sharp ear pain or a sudden decrease in ear pain Drainage from the ear that may be bloody. Forcefully blowing your nose causes air to rise up to fill the space in your middle ear. In most cases. the doctor uses a rubber bulb attached to the otoscope to blow a puff of air into the ear. If it is ruptured. Sometimes the sound is loud enough for other people to hear. The doctor may also test your hearing to determine how much effect the ruptured eardrum has had on your hearing. or resemble pus Ear noise or buzzing Hearing loss that may be partial or complete in the affected ear Episodic ear infections Facial weakness or dizziness How Is a Ruptured Eardrum Diagnosed? If you have any of the symptoms of a ruptured eardrum. such as an explosion or a sudden blast of loud music. Sometimes. So can an acoustic trauma caused by a sudden loud noise.A head injury or an ear slap can cause the eardrum to rupture. If the eardrum is not ruptured. clear. If this is the case. Normally this will cause the eardrum to balloon outward. it will move when the air hits it. But if there is a hole in the eardrum. An otoscope is an instrument with a light that's used to look inside the ear. the doctor will be able to see it. it won't." Some people are surprised to hear air coming out their ear when they blow their nose. What Are the Symptoms of a Ruptured Eardrum? Some people don't notice any symptoms of a ruptured eardrum. he or she may use a tuning fork to test it.

You'll also need to use a shower cap or place cotton coated with petroleum jelly in your outer ear when you shower to keep water out.headphones to determine your level of hearing. no specific treatment is needed for a ruptured eardrum. Normal hearing returns usually after the eardrum heals. That means no swimming or diving until the doctor says the eardrum is healed. How Is a Ruptured Eardrum Treated? Typically. for perforations that involve the edges of the eardrum. It's also important to see a doctor to remove a foreign object in your ear rather than try to remove it yourself. Other precautions include:     Not using medicine other than what's prescribed by your doctor in your ear Taking all the medicine prescribed by the doctor Protecting the ear from cold air Avoiding blowing your nose while the ear heals How Can a Ruptured Eardrum Be Prevented The two most important steps you can take to prevent a ruptured eardrum are to avoid putting any object into your ear -. The surgery is usually done on an outpatient basis.to prevent an ear infection or treat an existing infection. the doctor may put a patch over the eardrum. If the eardrum is slow to heal. the doctor may recommend using an over-the-counter pain medication such as acetaminophen or ibuprofen.even to clean it -. Surgery is most commonly used for large perforations. Warmth may be applied also to relieve discomfort. While the eardrum heals. During the procedure. In some cases. surgery may be needed to repair a ruptured eardrum. you'll need to keep the ear dry. . If the ruptured eardrum is causing you pain. the doctor will attach a piece of your own tissue to the eardrum to rebuild the eardrum. or for ruptured eardrums caused by an ear infection. the vast majority of ruptured eardrums heal within three months.and to treat ear infections promptly. Most hearing loss due to a ruptured eardrum is temporary. Your doctor may prescribe an antibiotic -either oral or in the form of eardrops -. which usually takes a couple of hours.

You hear sounds because of this vibration. The tympanic membrane is a thin tissue that divides your middle ear and outer ear canal. The pressure caused by the . When you have an ear infection. especially in children. so your hearing can suffer if your eardrum is damaged. the condition can cause permanent hearing loss. A ruptured eardrum is also called a perforated eardrum. What Is an Eardrum Rupture? An eardrum rupture is a small hole or tears in your eardrum. or tympanic membrane. Causes of Eardrum Rupture Infection Ear infections are a common cause of eardrum rupture. The vibration continues through the bones of the middle ear. In rare cases. This membrane vibrates when sound waves enter your ear. fluids accumulate behind the eardrum.2.

Any type of trauma to the ear or side of the head can cause a rupture. Pressure Changes Other activities that cause a change of pressure in the ear can also lead to a perforated eardrum. Acoustic trauma—or damage to the ear due to extremely loud noises—can cause your eardrum to rupture. Part 3 of 5: Symptoms . Even cleaning your ears with cotton swabs can be potentially damaging to your eardrum if you are not careful. However. These include:    scuba diving flying in an airplane driving at high altitudes Injury or Trauma An injury can also rupture your eardrum.buildup of fluids can cause the tympanic membrane to break or rupture. these cases are not as common.

you might suffer from additional symptoms. and fluids that are watery. It can remain steady throughout the day. You can also experience tinnitus —a ringing or buzzing in the ears. or it can increase or decrease in intensity. The eardrum at this point is ruptured. For some. the pain may be severe. Every person experiences the pain differently. or filled with pus may drain from the affected ear. Usually the ear begins to drain once the pain goes away. such as dizziness or a weakness in your facial muscles. Part 4 of 5: Treatment .Symptoms of Eardrum Rupture Pain is the main symptom of eardrum rupture. You may have some temporary hearing loss. If your eardrum was severely ruptured. or a reduction in hearing in the affected ear. bloody.

One simple remedy is to place a warm.Treatment for Eardrum Rupture Treatments for an eardrum rupture are mainly designed to relieve pain and to eliminate or prevent infection. Patching involves placing a medicated paper patch over the tear in the membrane. Patching If your ear does not heal on its own. You may also be told to use both forms of medication. dry compress on your ear several times daily. The patch encourages the membrane to grow back together. You can ease the pain of a ruptured eardrum at home with heat and pain relievers. surgery may be required to patch the hole in the eardrum. Surgery In rare cases. your doctor might decide to patch the eardrum. Your doctor may prescribe antibiotics in an oral pill form or as medicated eardrops. Antibiotics Antibiotics will clear up the infection that might have led to your eardrum rupture. They will also protect you from developing new infections as a result of the perforation. A surgical repair of a perforated eardrum is .

your surgeon takes tissue from another area of your body and grafts it onto the hole in your eardrum.called tympanoplasty. It is important to keep your ear dry to prevent further infection. Most people with ruptured eardrums experience only a temporary hearing loss. You can usually expect a full recovery within eight weeks. You can promote healing by not blowing your nose any more than absolutely necessary. Your doctor will most likely ask you to avoid swimming until your ear heals. Outlook. and Prevention of Future Ruptures A ruptured eardrum often heals without any invasive treatment. You can gently stuff your ears with cotton when you bathe to prevent water from entering the ear canal. . During tympanoplasty. Blowing your nose creates pressure in your ears. The increased pressure can be painful and can also slow your eardrum’s healing. Recovery.

if it is caused by an injury or becomes infected. Q-tip. Infections can cause a hole in the eardrum as a side effect of otitis media. pain. In patients with chronic Eustachian tube problems the ear drum may become weakened and open up. Symptoms of acuteotitis media (middle ear fluid with signs of infection) include a senese of fullness in the ear.there may be infected or bloody drainage from the ear. some hearing loss. is called a perforated eardrum. infection. or chronic Eustachian tube disorders.3. A perforated eardrum is often accompanied by decreased hearing and sometimes liquid discharge. The middle ear is connected to the nose by the Eustachian tube. A perforated eardrum from trauma can occur:  • If the ear is struck directly  • With a skull fracture  • After a sudden explosion  • If an object (such as a bobby pin. In this case. and spontaneous rupture of the eardrum. WHAT CAUSES EARDRUM PERFORATION? The causes of an eardrum hole are usually from injury. hearing loss. A hole or rupture in the eardrum. The medical term for eardrum is tympanic membrane. which equalizes pressure in the middle ear. resulting in a perforation. a thin membrane that separates the ear canal and the middle ear. On some occasions a small hole may remain in the eardrum after a . and fever. The perforation may be accompanied by pain. or stick) is pushed too far into the ear canal Middle ear infections may cause pain.

It also may prevent the development of cholesteatoma (skin cyst in the middle ear). Usually with closure of the ear drum.previously placed pressure-equalizing (PE) tube falls out or is removed by a physician. Working with a microscope. nose and throat physician) may choose to observe the perforation over time to see if it will close on its own. a hearing test should be performed. If your physician feels that a paper patch will not provide prompt or adequate closure of the . which can cause chronic infection and destruction of ear structures.although some may take several months to heal. During the healing process the ear must be protected from water and trauma. He or she might try to patch a patient•s eardrum in the office. and lessened tinnitus. hearing is improved. Several patches may be required before the perforation closes completely. HOW IS A PERFORATED EARDRUM TREATED? Before attempting any correction of the perforation.. an otolaryngologist (your ear. or swimming (which could cause ear infection). hearing loss may be serious. out of place. If severe injury (e. How is hearing affected by a perforated eardrum? HOW IS HEARING AFFECTED BY A PERFORATED EARDRUM? Usually the size of the perforation determines the level of hearing loss--a larger hole will cause greater hearing loss than a smaller hole. your doctor may touch the edges of the eardrum with a chemical to stimulate growth and then place a thin paper patch on the eardrum. skull fracture) moves the bones in the middle ear that send out sound. Eardrum perforations that do not heal on their own may require surgery.g. Most eardrum holes resulting from injury or an acute ear infection heal on their own within weeks of opening. The benefits of closing a perforation include prevention of water entering the middle ear while showering. the loss of hearing can be great and tinnitus (ringing in the ear) may occur. improved hearing. bathing. If the perforation is very small. or injuries the inner ear. If the perforated eardrum is caused by a sudden traumatic or violent event. Chronic infection as a result of the perforation can cause longer lasting or worsening hearing loss.

or if paper patching does not help. 4. .hole in the eardrum. and is often done in the physician's office. Your doctor will advise you regarding the proper care of a hole in the eardrum. A small procedure to repair a perforated eardrum is an option if it does not heal by itself. but most involve placing a patch across the perforation to allow healing. surgery may be required. Complications sometimes occur such as hearing loss and infection in the middle ear. especially if you have hearing loss. bringing back or improving hearing. Surgery is typically quite successful in repairing the perforation. The name of the procedure is tympanoplasty. There are a variety of options for treatment. Perforated Eardrum A torn (perforated) eardrum is not usually serious and often heals on its own without any complications.

Behind the eardrum are three tiny bones (ossicles). tiny perforations may only cause minimal loss of hearing. . a small perforation which is not close to the ossicles. The middle ear is connected to the back of the nose by the Eustachian tube. It can affect hearing. Also. This allows air in and out of the middle ear. The ear is divided into three parts . It lies between the outer and middle ear.the outer. The cochlea converts the vibrations to sound signals which are sent down a nerve to the brain. What is a perforated eardrum and what problems can it cause? A perforated eardrum is a hole or tear that has developed in the eardrum. For example. which we 'hear'. The middle ear behind the eardrum is normally filled with air. say. Sound waves come into the outer (external) ear and hit the eardrum. Larger perforations may affect hearing more severely. middle and inner ear. the extent of hearing loss can vary greatly. The vibrations pass from the eardrum to these middle ear bones. causing the eardrum to vibrate.What is the eardrum and how do we hear? The eardrum (also called the tympanic membrane) is a thin skin-like structure in the ear. However. if the tiny bones (ossicles) are damaged in addition to the eardrum then the hearing loss would be much greater than. The bones then transmit the vibrations to the cochlea in the inner ear.

which can damage the eardrum. wax or infection present in the ear. This can sometimes damage the eardrum. In this situation you often have a discharge from the ear as pus runs out from the middle ear. What can cause a perforated eardrum? Causes include:  Infections of the middle ear. The shock waves and sudden sound waves can tear (perforate) the eardrum. with a perforation. However. a punch to the ear.Also.  A sudden loud noise . These are tiny tubes that are placed through the eardrum. They are used to treat glue ear. you are at greater risk of developing an ear infection. This is because the eardrum acts as a barrier to bacteria and other germs that may get into the middle ear. from a nearby explosion. when descending in an aircraft. as they allow any mucus that is trapped in the middle ear to drain out from the ear. sometimes it is difficult to see the eardrum if there is a lot of inflammation.for example. For example. However.  Direct injury to the ear . Pain in the ear due to a tense eardrum is common during height (altitude) changes when flying. This occurs when you suddenly have a change in air pressure and there is a sharp difference in the pressure of air outside the ear and in the middle ear.  Poking objects into the ear. See separate leaflet called Barotrauma of the Ear. This is often the most severe type of perforation and can lead to severe hearing loss and ringing in the ears (tinnitus). there is a tiny perforation in the eardrum (that usually soon heals).for example. a perforated eardrum only happens rarely in extreme cases.  Grommets.  Barotrauma. . How is a perforated eardrum diagnosed? A doctor can usually diagnose a torn (perforated) eardrum simply by looking into the ear with a special torch called an otoscope. When a grommet falls out.

and improving hearing. It is best to avoid water getting into the ear whilst it is healing. In some cases. a doctor who is an ear specialist will advise on the pros and cons of treatment versus leaving it alone. Many people have a small permanent perforation with no symptoms or significant hearing loss. swimmers may prefer to have a perforation repaired. Some ear drops can potentially damage the nerve supply to the ear so your doctor will select a type that does not have this risk. Also. to an operation called tympanoplasty to repair the eardrum. Treatment is mainly considered if there is hearing loss. However. it will usually heal. not all people with an unhealed perforation need treatment. a doctor may prescribe antibiotic medicines if there is an infection or risk of infection developing in the middle ear whilst the eardrum is healing. Tympanoplasty is usually successful in fixing the perforation.What is the treatment for a perforated eardrum? No treatment is needed in most cases A torn (perforated) eardrum will usually heal by itself within 6-8 weeks. It is a skin-like structure and. like skin that is cut. as getting water in the middle ear can increase the risk of having an ear infection. Surgical treatment is sometimes considered A small procedure is an option to treat a perforated drum that does not heal by itself. For example. or will give you medication by mouth. It is best not to swim until the eardrum has healed. If you have a perforation that has not healed by itself. . a perforated eardrum gets infected and needs antibiotics. Medical treatment Occasionally. your doctor may advise that you put some cotton wool or similar material into your outer ear whilst showering or washing your hair. as this may improve if the perforation is fixed. There are various techniques ranging from placing some chemicals next to the torn part of the drum to encourage healing.