A burst eardrum, also known as a perforated tympanic membrane, is a hole in the thin tissue that separates the ear canal from the middle ear. This membrane is essential for hearing and protects the middle ear from external elements like dirt and bacteria. When compromised, it can affect sound transmission and increase the vulnerability of the middle ear to infection.
How an Eardrum Bursts
An eardrum can rupture through several common mechanisms. Middle ear infections, or otitis media, are a frequent cause, especially in children. Fluid accumulating behind the eardrum during an infection creates pressure that can eventually cause the membrane to tear or burst.
Trauma to the ear is another way an eardrum can rupture. This can occur from a direct blow to the ear or head, or from inserting objects like cotton swabs or hairpins too far into the ear canal. Sudden, intense loud noises, such as from an explosion or gunfire, can generate shock waves strong enough to perforate the eardrum. Rapid changes in air pressure, known as barotrauma, can also lead to a rupture. This often happens during activities like flying, scuba diving, or a forceful slap to the ear.
What You Might Feel
When an eardrum bursts, individuals may experience a range of symptoms. Often, there is a sudden, sharp ear pain, which may then subside quickly as pressure is relieved. Following this, clear, pus-filled, or bloody fluid may drain from the ear.
Hearing loss is a common symptom, which can range from a mild muffled sensation to more significant impairment in the affected ear. Some people also report ringing or buzzing sounds in the ear, known as tinnitus. Other symptoms include dizziness (vertigo), sometimes leading to nausea or vomiting.
The Healing Journey
Most burst eardrums heal naturally without medical intervention. The body’s natural healing process involves new cells growing from the edges of the perforation to close the hole.
This process typically takes a few weeks, though larger perforations may require several months to fully close. To support healing, keep the ear dry by avoiding swimming and protecting it during showering or bathing. Unless prescribed by a doctor, avoid using ear drops or inserting objects into the ear canal.
When Healing Doesn’t Go As Planned
While most eardrums heal on their own, some perforations may not close naturally, leading to chronic issues. A persistent hole can increase the risk of recurrent middle ear infections as the eardrum no longer provides a protective barrier. These repeated infections can cause ongoing fluid discharge from the ear and may result in persistent hearing loss.
Rarely, a chronic perforation can allow skin cells and earwax to enter the middle ear, forming a cyst called a cholesteatoma. This cyst can grow and produce proteins that may damage the delicate bones within the middle ear, leading to permanent hearing impairment. An unhealed perforation can also rarely lead to the spread of infection to the mastoid bone behind the ear, a condition known as mastoiditis.
When to See a Doctor and Treatment Options
It is important to seek medical attention if symptoms of a burst eardrum are experienced, especially if there is persistent pain, ongoing fluid discharge, significant hearing loss, or no improvement after a few weeks. A doctor will examine the ear using an otoscope, a lighted instrument that allows visualization of the eardrum.
Treatment approaches depend on the size of the perforation and its underlying cause. Many small tears are simply observed, as they often heal spontaneously. If an infection is present or to prevent one, antibiotics may be prescribed. For perforations that do not heal on their own, a doctor might apply a special patch to the eardrum to encourage closure. If these methods are insufficient, surgical repair, known as tympanoplasty, may be recommended. This procedure involves grafting tissue to close the hole, aiming to restore hearing and prevent complications.