Definition

Tympanic membrane perforation, or a ruptured eardrum, is a hole in the eardrum (tympanic membrane).

The eardrum is a very thin membrane made of tissue that separates the middle ear from the ear canal. The eardrum aids in hearing and in preventing bacteria and other foreign matter from entering the middle ear.

A ruptured eardrum may heal itself and not require treatment. Healing usually takes about a month. However, eardrums that have ruptured because of a chronic ear infection usually require treatment.

Patients with a ruptured eardrum may be at an increased risk of an ear infection, because the opening in the membrane allows bacteria to enter the middle ear and cause infection.

The Eardrum

si55550603_97870_1_eardrum
© 2009 Nucleus Medical Art, Inc.

Causes

Eardrums may rupture from a variety of causes, including:

  • Puncture from use of a Q-tip or other device inserted in the ear canal
  • Damage to the ear, such as being slapped or hit
  • Pressure building up inside the middle ear (eg, scuba diving)
  • Ear infections

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. The following factors increase your chance of rupturing an eardrum:

  • Scuba diving
  • Having an ear infection
  • Receiving an injury to the ear
  • Inserting objects in the ear

Symptoms

You may not have any symptoms. Symptoms that sometimes occur include:

  • Earache, severe and increasing in its severity
  • Earache, severe, then subsides and is followed by discharge from the ear
  • Drainage from the ear—may have blood or pus
  • Hearing loss or difficulty hearing out of the affected ear
  • Buzzing or other noise in the ear

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. During the exam, the doctor will examine the ear with an otoscope and look to see if the eardrum has been perforated. The perforation is sometimes difficult to see because of the thick drainage in the ear.

Doctors may also perform an audiology test to determine if any hearing loss has occurred.

Treatment

While many ruptured eardrums will heal on their own, many may also require treatment to heal properly. Talk with your doctor about the best treatment plan for you. Treatment options include:

Medications

For ruptured eardrums caused by ear infection, antibiotics will be administered to clear up the infection. Antibiotics may also be prescribed to prevent infections that may occur because of the perforation.

Pain relievers may also be taken to ease pain and discomfort caused by the perforation.

Applying a warm compress to the affected ear can also ease pain and discomfort. The ear should be kept dry at all times, and cotton balls should be inserted in the ear while showering. Swimming should be avoided.

Surgery

If the eardrum does not heal itself, surgery may be required to repair the perforation.

If you are diagnosed with a ruptured eardrum, follow your doctor's instructions.

Prevention

To help reduce your chance of rupturing an eardrum, take the following steps:

  • Do not stick Q-tips and other objects inside the ear.
  • Treat ear infections promptly and thoroughly.