Perforated Eardrum

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

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.

Diagnosis

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.

Expected Duration

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.

Prevention

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 ( and ) that cause middle-ear infections.