(Tympanic Membrane Perforation; Perforated Eardrum)
A ruptured eardrum is a hole in the tympanic membrane (eardrum). The eardrum helps with hearing and lower the risk of bacteria and matter from entering the middle ear.
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Eardrums may rupture due to:
- Ear infections
- A puncture from inserting an object like a cotton swab in the ear canal
- Trauma to the ear, such as being slapped over the ear or an explosion
- Pressure buildup in the middle ear, which can happen during activities like scuba diving
- A complication from treatments like ear irrigation or foreign body removal
Things that may raise the risk of a ruptured eardrum are:
- Having an ear infection
- A history of eardrum ruptures or ear surgery, such as ear tube placement
- Scuba diving
- Trauma to the ear
- Inserting objects in the ear
Some people may not have symptoms. Others may have:
- Severe ear pain that gradually gets worse over time
- Ear pain that is severe, gets better, and then is followed by leakage from the ear
- Blood or pus leaking from the ear
- Problems hearing
- Buzzing or other noise in the ear
People who have a ruptured eardrum are at higher risk for an ear infection. This is because the opening in the membrane allows bacteria to enter the middle ear and cause infection.
The doctor will ask about symptoms and past health. A physical exam will be done. It will focus on the ear. A scope will be used to look inside the ear. A probe may also be used to check the eardrum function. Hearing tests may also be done.
Most ruptured eardrums heal on their own with time. Pain relievers can help to manage symptoms during this time.
Treatment will be needed to help an eardrum that does not heal on its own. This can be done with surgery to patch the tear or hole.
The risk of a ruptured eardrum may be lowered by:
- Not sticking objects like cotton swabs inside the ear
- Getting treatment right away for any symptoms that point to an ear infection
- Using ear protection when around sudden loud noises, such as explosives
- Protecting the ear from sudden changes in pressure, such as when scuba diving
- Evaluation and management of middle ear trauma. Available at: https://www.dynamed.com/management/evaluation-and-management-of-middle-ear-trauma.
- Osetinsky LM, Hamilton GS 3rd, Carlson ML. Sport Injuries of the Ear and Temporal Bone. Clin Sports Med. 2017 Apr;36(2):315-335.
- Tympanic membrane perforation. University of California, Irvine School of Medicine website. Available at: http://www.ent.uci.edu/learning-center/blog/tympanic-membrane-perforations.asp.
- Elizabeth Margaret Prusak, MD
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