A ruptured eardrum is a hole or tear in your eardrum, the thin tissue that separates your ear canal from your middle ear.
A ruptured eardrum (tympanic membrane perforation) is a hole or tear in the thin tissue that separates the ear canal from the middle ear (eardrum).
A ruptured eardrum can result in hearing loss. It can also make the middle ear vulnerable to infections.
A ruptured eardrum usually heals within a few weeks without treatment. But sometimes it requires a patch or surgical repair to heal.
A ruptured (perforated) eardrum prevents the proper transmission of sound waves to the middle ear and leaves the middle ear vulnerable to infectious agents, water and other foreign substances.
Signs and symptoms of a ruptured eardrum may include:
Call your health care provider if you have signs or symptoms of a ruptured eardrum. The middle and inner ears are made up of delicate structures that are sensitive to injury or disease. It is important to try to figure out the cause of ear symptoms and determine whether a ruptured eardrum has occurred.
Causes of a ruptured (perforated) eardrum may include:
Barotrauma. Barotrauma is stress exerted on the eardrum when the air pressure in the middle ear and the air pressure in the environment are out of balance. If the pressure is severe, the eardrum can rupture. Barotrauma is most often caused by air pressure changes associated with air travel.
Other events that can cause sudden changes in pressure — and possibly a ruptured eardrum — include scuba diving and a direct blow to the ear, such as the impact of an automobile air bag.
The middle ear has three small bones — the hammer, or malleus; the anvil, or incus; and the stirrup, or stapes. The eardrum keeps the bones away from the outer ear. A narrow path called the eustachian tube joins the middle ear to the back of the nose and upper part of the throat. The cochlea, a snail-shaped structure, is part of your inner ear.
The eardrum (tympanic membrane) has two primary roles:
If the eardrum ruptures, uncommon problems can occur, especially if it fails to self-heal after three to six months. Possible complications include:
Middle ear cyst (cholesteatoma). Although very rare, this cyst, which is composed of skin cells and other debris, can develop in the middle ear as a long-term result of eardrum rupture.
Ear canal debris normally travels to the outer ear with the help of ear-protecting earwax. If the eardrum is ruptured, the skin debris can pass into the middle ear and form a cyst.
A cyst in the middle ear provides a friendly environment for bacteria and contains proteins that can damage the bones of the middle ear.
Follow these tips to avoid a ruptured (perforated) eardrum:
Protect your ears during flight. If possible, don't fly if you have a cold or an active allergy that causes nasal or ear congestion. During takeoffs and landings, keep ears clear with pressure-equalizing earplugs, yawning or chewing gum.
Or use the Valsalva maneuver — gently pushing air into the nose, as if blowing your nose, while pinching the nostrils and keeping the mouth closed. Don't sleep during ascents and descents.
Your provider or an ENT specialist can often determine if you have a ruptured (perforated) eardrum with a visual inspection using a lighted instrument (otoscope or microscope).
Your provider may conduct or order additional tests to determine the cause of your ear symptoms or to detect the presence of any hearing loss. These tests include:
Tuning fork evaluation. Tuning forks are two-pronged, metal instruments that produce sounds when struck. Simple tests with tuning forks can help your provider detect hearing loss.
A tuning fork evaluation may also reveal whether hearing loss is caused by damage to the vibrating parts of the middle ear (including the eardrum), damage to sensors or nerves of the inner ear, or damage to both.
Most ruptured (perforated) eardrums heal without treatment within a few weeks. Your provider may prescribe antibiotic drops if there's evidence of infection. If the tear or hole in the eardrum doesn't heal by itself, treatment will likely involve procedures to close the tear or hole. These may include:
Eardrum patch. If the tear or hole in the eardrum doesn't close on its own, an ENT specialist may seal it with a paper patch (or a patch made of other material).
With this office procedure, your ENT doctor may apply a chemical to the edges of the tear, which can promote ear drum healing, and then apply a patch over the hole. The procedure may need to be repeated more than once before the hole closes.
Surgery. If a patch doesn't result in proper healing or your ENT doctor determines that the tear isn't likely to heal with a patch, he or she may recommend surgery.
The most common surgical procedure is called tympanoplasty. Your surgeon grafts a patch of your own tissue to close the hole in the eardrum. This procedure is done on an outpatient basis. In an outpatient procedure, you can usually go home the same day unless medical anesthesia conditions require a longer hospital stay.
In some cases, your surgeon treats a ruptured eardrum with a procedure called tympanoplasty. Your surgeon grafts a tiny patch of your own tissue to close the hole in the eardrum.
A ruptured (perforated) eardrum usually heals on its own within weeks. In some cases, healing takes months. Until your provider tells you that your ear is healed, protect it by:
If you have signs or symptoms of a perforated eardrum, you're likely to start by seeing your provider. However, your provider may refer you to a specialist in ear, nose and throat (ENT) disorders (otolaryngologist).
Here's some information to help you prepare for your appointment.
Make a list ahead of time that you can share with your provider. Your list should include:
If you think you have signs or symptoms of a ruptured eardrum, you may want to ask your provider some of the following questions.
Don't hesitate to ask other questions you have.
Your provider is likely to ask you a number of questions, including:
If you think that you have a ruptured eardrum, be careful to keep your ears dry to prevent infection.
Don't go swimming until your condition has been evaluated and discussed with your provider. To keep water out of the ear when showering or bathing, use a moldable, waterproof silicone earplug or put a cotton ball coated with petroleum jelly in the outer ear.
Don't put medication drops in the ear unless your provider prescribes them specifically for infection related to the perforated eardrum.