A ruptured or perforated eardrum is an opening in the tympanic membrane (eardrum).
Alternative Names
Tympanic membrane perforation; Eardrum - ruptured; Eardrum - perforated; Eardrum - punctured
Causes, incidence, and risk factors
The tympanic membrane (eardrum) separates the outer ear from the middle ear. The membrane vibrates when sound waves strike it, and this starts the process that converts the sound wave into a nerve impulse that travels to the brain. When the eardrum is damaged, the hearing process is interrupted. The eardrum also acts as a barrier to keep outside material (such as bacteria) from entering the middle ear. When the eardrum is perforated, bacteria can easily travel to the middle ear -- causing an infection. Damage to the eardrum can occur from acoustic trauma such as direct injury or barotrauma (pressure-induced damage). Inserting cotton-tipped swabs or small objects into the ear to clean them sometimes causes a perforation of the eardrum. Foreign objects in the ear are another cause of perforated eardrum. Ear infections may cause a ruptured eardrum as the pressure of fluid in the middle ear increases. Conversely, a ruptured eardrum can cause ear infections because the eardrum is no longer intact, and bacteria can enter the middle ear.
Signs and tests
An inspection of the ear with an otoscope shows opening in the tympanic membrane and may show the bones of the middle ear. Sometimes visualization of the tympanic membrane is difficult because of drainage from the ear (pus). Audiology/audiometry testing may show the extent of hearing loss .
Treatment
Ruptured or perforated eardrum usually heals by itself within 2 months. The treatment goals include relieving pain and preventing infection. Antibiotics may be used to prevent infection or to treat existing infection. Analgesics , including over-the-counter medications, may be used to relieve pain. Occasionally, the health care provider may place a patch over the eardrum while it heals. Surgical repair of the eardrum may be needed, if the eardrum does not heal on its own ( tympanoplasty ). Warmth to the ear may help relieve discomfort. Keep the ear clean and dry while healing. Cotton balls should be placed in the ear while showering or shampooing to prevent water entering the ear.
Expectations (prognosis)
A ruptured or perforated eardrum may be uncomfortable, but it usually heals by itself within 2 months. Any hearing loss is usually temporary.
Calling your health care provider
Call your health care provider if symptoms indicate ruptured or perforated eardrum. Call for an appointment with your health care provider if symptoms persist for longer than 2 months in spite of medical treatment. Call your health care provider if you have a ruptured or perforated eardrum and persistent fever , general ill feeling , or hearing loss develops.
Prevention
Do not insert objects into the ear canal even to clean it. Foreign objects should only be removed by the health care provider. Have ear infections treated promptly.