A ruptured eardrum (perforation of the eardrum) is a hole or tear in the thin tissue that separates the ear canal from the middle ear (eardrum).

A ruptured eardrum can lead to hearing loss. It can also make the middle ear vulnerable to infection.

A ruptured eardrum usually heals within a few weeks without treatment. But sometimes the case requires the use of a plaster or surgical restoration to heal.

symptoms

Signs and symptoms of a ruptured eardrum may include:

• Ear pain that may decrease quickly
• Discharge from the ear that resembles mucus or is mixed with pus or blood
• hearing loss
• Tinnitus
• Feeling dizzy
• Nausea or vomiting can result from vertigo

When do you see a doctor?

Contact your doctor if you have signs or symptoms of a ruptured eardrum. The inner and middle ear are made up of delicate structures that are sensitive to injury or disease. Therefore, it is important to try to identify the cause of your ear symptoms and to determine whether or not you have a ruptured eardrum.

Causes of a ruptured (perforated) eardrum may include:

Middle ear infection (otitis media). A middle ear infection often causes fluid to build up in the middle ear. The pressure of these fluids can perforate the eardrum.

Barotrauma. Barotrauma is stress on the eardrum when the air pressure in the middle ear is out of balance with the air pressure in the surrounding environment. If the pressure is severe, the eardrum may perforate. Barotrauma is often caused by changes in air pressure associated with air travel.

Other events that can cause sudden changes in pressure — possibly perforation of the eardrum — include scuba diving and a direct blow to the ear, such as when an automobile air bag hits it.

Loud sounds or explosions (acoustic shock). In rare cases, a loud sound or explosion, such as from an explosion or gunshot, which essentially causes a strong sound wave, can perforate the eardrum.

• Foreign objects entering your ear. Small objects — such as cotton swabs or bobby pins — can puncture or tear the eardrum.
• Severe trauma to the head. A severe injury, such as a skull base fracture, can dislocate or damage the middle and inner ear organs, including the eardrum.

complications

The eardrum (tympanic membrane) has two main functions:

• Hearing. The eardrum vibrates when sound waves hit it – the first step by which parts of the middle and inner ear convert sound waves into nerve impulses.
• Protection. The eardrum is also a protective barrier that protects the middle ear from water, bacteria, and other foreign matter.

In the event of a ruptured eardrum, uncommon problems can occur, especially if self-healing fails after three to six months. Its potential complications include:

• hearing loss. Hearing loss is usually temporary, lasting only until the tear or hole in the eardrum heals. The size and location of the tear affects the degree of hearing loss.

Middle ear infection (otitis media). A ruptured “perforation” of the eardrum allows bacteria to enter the ear. If the eardrum does not heal, a small number of people may become susceptible to persistent infections (recurrent or chronic infections). In this small group, hearing loss or chronic secretions can occur.

• A cyst in the middle ear (cholesteatoma). Although rare, this cyst of skin cells and other debris may appear in the middle ear as a long-term result of a ruptured eardrum.

The remains of the ear canal naturally move into the outer ear with the help of protective earwax. A ruptured eardrum may also lead to skin debris entering the middle ear and forming a cyst.

A middle ear cyst is a favourable environment for bacteria that contain proteins that may damage the middle ear bones.

protection

Follow these guidelines to avoid perforating the eardrum:

• Treat middle ear infections. Be aware of the signs and symptoms of middle ear infections, such as earache, fever, nasal congestion, and hearing loss. Children with otitis media are often fussy and may refuse to eat. Seek a doctor for prompt evaluation to prevent possible eardrum rupture.
• Protect your ears during flights. Don’t fly (if possible) if you have a cold or an active allergy that could be causing nasal or ear congestion. While on and off the plane, protect your ears with either pressure-modifying earplugs, yawning, or chewing gum.

Or use the Valsalva method — gently blowing air out of your nose, as if you were blowing your nose, while holding your nostrils with your mouth closed. Do not sleep during the ups and downs.

• Keep your ears free of foreign objects. Never attempt to dislodge secretions or hardened earwax with objects such as cotton-tipped swabs, a piece of paper, or a hairpin. These things can easily rupture or perforate the eardrum. Tell your children about the harm that may occur if they put foreign objects in their ears.
• Watch out for the sounds of explosions. Avoid activities that expose your ears to blasting sounds. If your hobby or job involves planned activities that create blasting sounds, protect your ears from damage as long as you don’t have to by wearing protective earplugs or earmuffs.