Tympanic membrane perforation

A ruptured eardrum is an opening or hole in the eardrum. The eardrum is a thin piece of tissue that separates the outer and middle ear. Damage to the eardrum may harm hearing.

Causes
Ear infections may cause a ruptured eardrum. This occurs more often in children. The infection causes pus or fluid to build up behind the eardrum. As the pressure increases, the eardrum may break open (rupture).

Damage to the eardrum can also occur from:

  • A very loud noise close to the ear, such as a gunshot
  • A rapid change in ear pressure, which may occur when flying, scuba diving, or driving in the mountains
  • Foreign objects in the ear
  • Injury to the ear (such as from a powerful slap or explosion)
  • Inserting cotton-tipped swabs or small objects into the ears to clean them 
Symptoms
Ear pain may suddenly decrease right after your eardrum ruptures.

After the rupture, you may have:

  • Drainage from the ear (drainage may be clear, pus, or bloody)
  • Ear noise/buzzing
  • Earache or ear discomfort
  • Hearing loss in the involved ear (hearing loss may not be total)
  • Weakness of the face, or dizziness (in more severe cases) 
Exams and Tests
The doctor will look in your ear with an instrument called an otoscope. If the eardrum is ruptured, the doctor will see an opening in it. The bones of the middle ear may also be visible.

Pus draining from the ear may make it harder for the doctor to see the eardrum.

Audiology testing can measure how much hearing has been lost.

Treatment
You can take steps at home to treat ear pain.

  • Put warm compresses on the ear to help relieve discomfort. 
  • Use medicines such as ibuprofen or acetaminophen to ease pain.

Keep the ear clean and dry while it is healing.

  • Place cotton balls in the ear while showering or shampooing to prevent water from entering the ear.
  • Avoid swimming or putting your head underneath the water. 

Your health care provider may prescribe antibiotics (oral or ear drops) to prevent or treat an infection.

Sometimes the health care provider may place a patch over the eardrum to speed healing. Surgical repair of the eardrum (tympanoplasty) may be needed if the eardrum does not heal on its own.

Outlook (Prognosis)
The opening in the eardrum usually heals by itself within 2 months. Any hearing loss is most often short-term.

Rarely, other problems may occur, such as:

  • Long-term hearing loss
  • Spread of infection to the bone behind the ear (mastoiditis)
  • Long-term vertigo and dizziness

 

Source: NIH   MedlinePlus