Perforated Eardrum: Causes, Symptoms, and Treatment

A perforated eardrum, commonly called a ruptured eardrum, occurs when a tear or hole develops in the thin membrane separating the ear canal from the middle and inner ear. This membrane plays a crucial role in responding to sound waves and in the overall hearing process.

Understanding Perforated Eardrums

Symptoms of a Perforated Eardrum

• Discharge from the ear, which may contain blood or pus
• Fever
• Severe pain in some cases
• Lingering discomfort in the ear, like “something isn’t right”
• Intense ear pain
• Vertigo (spinning sensation) with nausea or vomiting
• Sudden hearing loss
• Tinnitus (ringing in the ears)

If you experience these symptoms after a sudden injury or exposure to loud noise, it is important to see an ENT specialist or hearing care professional.

Causes of a Perforated Eardrum

• Trauma to the head or ear, such as car accidents
• Sudden exposure to loud sounds
• Fluid buildup, especially in children with middle or inner ear infections
• Barotrauma from pressure changes during scuba diving, air travel, or driving in mountains
• Cholesteatoma (benign tumor behind the eardrum)
• Ear infections caused by bacteria or viruses
• Insertion of foreign objects, such as cotton swabs or pens

Is a Perforated Eardrum Painful?

Pain from a perforated eardrum varies depending on the cause and severity. If caused by a foreign object, pain may be sharp initially but usually decreases over time. Infection-related ruptures tend to cause less pain. Some people may only experience mild discomfort. Prompt medical evaluation is important to identify the cause and ensure proper treatment.

Can You Still Hear with a Perforated Eardrum?

Typically, you can still hear as long as the middle and inner ear are not damaged. Most perforated eardrums heal naturally and restore normal hearing. Medical attention is critical to prevent permanent damage.

Impact on Hearing

A perforated eardrum disrupts its vibration, leading to muffled or reduced hearing. Hearing loss is usually temporary but may vary depending on the location and size of the tear. Untreated perforations over a long period may result in permanent damage.

Can I Wear a Hearing Aid with a Perforated Eardrum?

Once the eardrum has healed, most patients regain their hearing. Chronic perforations may benefit from hearing aids, particularly for conductive hearing loss. Sound perception generally remains clear, unlike sensorineural hearing loss. Consultation with a hearing professional is recommended for a personalized treatment plan.

Treatment for a Perforated Eardrum

Medical evaluation by an ENT or hearing professional is essential. Treatment may include pain management, antibiotics for infection, or surgical intervention such as tympanoplasty.

Is It an Emergency?

Perforated eardrums are usually not emergencies unless accompanied by a skull fracture with bleeding from the ear.

Healing Time

Healing time varies depending on perforation size and cause. Small tears often heal within a few weeks without medical intervention, whereas larger or complex tears may require several weeks to months and medical treatment.

• Small Perforations: Typically heal within weeks; avoid swimming or exposing the ear to excess moisture.
• Larger/Complex Perforations: May take longer and require patching or surgery.

Surgical Options

• Paper Patch Myringoplasty: Less invasive procedure for small tears using a thin sterile material to cover the perforation.
• Tympanoplasty: More extensive surgery using a graft from patient tissue, donor, or synthetic material for larger or complicated perforations. May include addressing the ear canal, middle ear, or inserting tympanostomy tubes.

Recovery After Surgery

• Keep Ear Dry: Avoid showering initially; cover the operated ear if needed.
• Monitor Bleeding: Slight bleeding is normal; consult doctor if persistent.
• Avoid Blowing Nose: Prevents pressure changes that could affect healing.
• Sneeze with Mouth Open: Reduces pressure on the healing ear.
• Limit Physical Activity: Avoid strenuous activity for a few days.
• Manage Pain: Use over-the-counter pain relief as recommended.

Permanent Damage

If the eardrum is permanently damaged, hearing aids can improve hearing and overall auditory experience.

Prevention

• Avoid Foreign Objects: Do not insert cotton swabs or other objects into the ear.
• Treat Ear Infections Promptly: Prevent prolonged infections and fluid buildup.
• Maintain Ear Pressure: Chew gum or yawn gently to stabilize pressure.
• Use Ear Protection in Noisy Environments: Wear earplugs or earmuffs at concerts, construction sites, or other loud areas.

Understanding causes, symptoms, and treatment options for a perforated eardrum is essential for maintaining hearing health. Prompt medical care, preventive measures, and hearing aids can help manage hearing challenges effectively.