A burst eardrum, or perforated tympanic membrane, is a hole or tear in the thin tissue separating the outer and middle ear. This membrane is important for hearing and protects the middle ear. A perforation can allow bacteria and moisture to enter the middle ear.
Recognizing the Signs
A primary sign of a burst eardrum is often sudden, sharp ear pain that quickly subsides as pressure is relieved. After this pain, fluid may drain from the ear, appearing clear, bloody, or pus-filled. This drainage can indicate an infection or the release of built-up fluid.
Hearing changes are also common, from muffled sounds to significant hearing loss. The extent of hearing reduction depends on the perforation’s size and location. Tinnitus, a ringing or buzzing sound, may also occur. Other symptoms include ear stuffiness or pressure, dizziness, vertigo, nausea, or vomiting.
Common Causes
A frequent reason for eardrum perforation is a middle ear infection. Fluid buildup during an infection creates pressure, causing the membrane to tear. When the eardrum ruptures, pain and pressure often diminish as fluid drains.
Sudden, intense loud noises, referred to as acoustic trauma, can also cause a perforation. Explosions or gunshots produce sound waves powerful enough to damage the eardrum. Rapid changes in air pressure, known as barotrauma, can stress the eardrum to the point of tearing. This can happen during air travel, particularly during takeoff and landing, or while scuba diving.
Inserting foreign objects into the ear, such as cotton swabs, bobby pins, or even small toys, represents another common cause of accidental perforation. These objects can directly puncture or tear the membrane. Severe head trauma, like a skull fracture or a direct blow to the ear, can also result in eardrum damage.
Seeking Medical Help and Treatment
If symptoms of a burst eardrum are present, seeking medical attention is advisable to prevent potential complications and assess hearing. A healthcare provider typically diagnoses a perforated eardrum by looking inside the ear with an otoscope, a lighted instrument that allows for a clear view of the eardrum. In some cases, a microscope may be used for a more detailed examination, and hearing tests, such as audiometry or tympanometry, might be conducted to evaluate hearing function.
Most burst eardrums heal on their own without specific treatment. However, if an infection is present or there is a risk of infection, a doctor may prescribe antibiotics, either orally or as eardrops. For pain management, over-the-counter pain relievers or applying a warm compress can provide relief. If the perforation is large or does not heal naturally within a few months, a specialist may recommend procedures like a patch (myringoplasty) to encourage closure or, in some instances, surgical repair (tympanoplasty) to mend the eardrum.
Healing and Prevention
Most burst eardrums heal spontaneously within a few weeks to several months. The healing timeline can vary depending on the size of the hole and whether an infection is present. During the healing period, it is important to keep the ear dry by using waterproof earplugs or cotton balls coated with petroleum jelly when showering or bathing. Unless specifically prescribed by a doctor, avoiding the use of over-the-counter ear drops is recommended, as some types can cause issues if they enter the middle ear.
If a perforated eardrum does not heal properly, potential complications can include chronic middle ear infections, persistent hearing loss, or, rarely, the development of a cholesteatoma, which is a skin growth in the middle ear. To help prevent future perforations, prompt treatment of ear infections is important. Additionally, refrain from inserting objects into the ear canal for cleaning or scratching. Taking precautions during activities that involve rapid pressure changes, such as chewing gum or yawning while flying, can also help protect the eardrums.