What Is It?

The eardrum is a thin membrane that separates your ear canal (the part that is open to the outside) from your middle ear. The eardrum, also called the tympanic membrane, is involved in hearing. Sound waves cause your eardrum to vibrate. This begins the process of converting the sound waves into an impulse that travels to your brain, where it is recognized as sound.

The eardrum is delicate and can be torn (perforated) easily, most often by an infection of the middle ear (otitis media) but also by other types of trauma, including:

• Inserting an object, such as a cotton swab or toothpick, too far into the ear (the most common cause of a perforated eardrum)
• A very loud noise, such as an explosion
• Trauma to the head, such as a skull fracture
• A blow to the ear
• Trauma to the ear caused by changes in air pressure (barotrauma) , such as during a plane flight or scuba diving

Symptoms of a perforated eardrum include:

• Earache
• Sudden or partial hearing loss
• Bleeding or discharge from the ear canal

The level of hearing loss depends on the size of the perforation and what caused it. Trauma to the ear or head can injure the middle ear, inner ear or both, and can produce severe hearing loss. If an explosion has torn the eardrum, you may have ringing in your ears (tinnitus) for several days, as well as hearing loss. If the perforated eardrum becomes infected, the hearing loss may worsen.

Your doctor will look into your ear using an instrument called an otoscope to see if the eardrum has torn. He or she also will test your hearing. If the doctor suspects you have a ruptured eardrum but cannot see the perforation easily, he or she may confirm the diagnosis by blowing pressurized air into your ear using a special machine.

Most perforated eardrums heal in a few weeks. Some take up to two months. Exposure to water or further trauma can slow the healing. Larger tears, or tears that do not heal on their own, may require surgery.

There are several steps you can take to prevent a perforated eardrum:

• If you prevent middle-ear infections, you can reduce the risk of a perforated eardrum. To help prevent infections, minimize certain environmental conditions — exposure to tobacco smoke, allergies, immune deficiency, chronic sinus infections, enlarged adenoids. Children also can receive immunizations against two common bacteria (Haemophilus influenzae and Streptococcus pneumoniae) that cause middle-ear infections.
• Do not insert cotton swabs into the ear canal during cleaning because this can tear the eardrum.
• If an object gets into your ear, have it removed by your doctor to minimize the risk of ear injury. Don’t try to take out the object yourself unless you can see it clearly, it is soft and you can remove it easily.
• Have all infections treated promptly to avoid complications.

If the hole is small, your doctor may allow it to heal on its own, and may have you take antibiotics to prevent infection while the eardrum heals. Keep water out of the injured ear, and avoid blowing your nose, which can cause pressure changes in the ear and disrupt healing.

Some holes may be patched in the office of an otolaryngologist (ear, nose and throat doctor). A thin paper patch is placed over your eardrum in combination with a chemical that encourages the eardrum to heal.

If your eardrum has not healed after two months, your doctor may recommend a surgery called tympanoplasty, which involves placing tissue over the eardrum. This is usually an outpatient procedure and has a high success rate.

During healing from the surgery, keep your ear dry by using cotton balls to protect your eardrum from water during showers or baths. Also, avoid blowing your nose, which can damage the healing tissue. Warm compresses, such as a warm, damp washcloth, or a heating pad can relieve some discomfort. Your doctor also may prescribe pain-relieving medication or recommend that you use over-the-counter pain medications.

Any time you have hearing loss, you should contact your doctor. If you are being treated for a perforated eardrum and have symptoms for more than two months, see your doctor for a follow-up evaluation.

The prognosis is excellent. Most perforated eardrums heal within two months without complications. Hearing loss is usually temporary, though some people do experience some level of permanent hearing loss. Occasionally, a chronic infection may cause a permanent perforation of the eardrum and some degree of permanent hearing loss.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.