Eardrum Rupture

What is an eardrum rupture?
An eardrum rupture is a small hole or tear in your eardrum, or tympanic membrane. The tympanic membrane is a thin tissue that divides your middle ear and outer ear canal.
This membrane vibrates when sound waves enter your ear. The vibration continues through the bones of the middle ear. Because this vibration allows you to hear, your hearing can suffer if your eardrum is damaged.
A ruptured eardrum is also called a perforated eardrum. In rare cases, this condition can cause permanent hearing loss.

CAUSES
Causes of eardrum rupture

Infection

Ear infections are a common cause of eardrum rupture, especially in children. During an ear infection, fluids accumulate behind the eardrum. The pressure from the fluid buildup can cause the tympanic membrane to break or rupture.

Pressure changes

Other activities can cause pressure changes in the ear and lead to a perforated eardrum. This is known as barotrauma, and it mainly occurs when the pressure outside the ear is drastically different from the pressure inside the ear. Activities that can cause barotrauma include:

• scuba diving
• flying in an airplane
• driving at high altitudes
• shock waves
• direct, forceful impact to the ear

Injury or trauma

Injuries can also rupture your eardrum. Any trauma to the ear or side of the head can cause a rupture. The following have been known to cause eardrum ruptures:

• getting hit in the ear
• sustaining an injury during sports
• falling on your ear
• car accidents

Inserting any kind of object, such as a cotton swab, fingernail, or pen, too far into the ear can harm your eardrum as well.
Acoustic trauma, or damage to the ear from extremely loud noises, can rupture your eardrum. However, these cases are not as common.

SYMPTOMS
Symptoms of eardrum rupture
Pain is the main symptom of eardrum rupture. For some, the pain may be severe. It can remain steady throughout the day, or it can increase or decrease in intensity.
Usually the ear begins to drain once pain goes away. At this point, the eardrum is ruptured. Watery, bloody, or pus-filled fluids may drain from the affected ear. A rupture that results from a middle ear infection usually causes bleeding. These ear infections are more likely to happen in young children, people with colds or the flu, or in areas with poor air quality.
You may have some temporary hearing loss or a reduction in hearing in the affected ear. You can also experience tinnitus, a constant ringing or buzzing in the ears, or dizziness.

DIAGNOSIS
Diagnosing eardrum ruptures
Your doctor can use several ways to determine if you have a ruptured eardrum:

• a fluid sample, in which your doctor tests fluids that may be leaking from your ear for infection (infection may have caused your eardrum to rupture)
• an otoscope exam, in which your doctor uses a specialized device with a light to look into your ear canal
• an audiology exam, in which your doctor tests your hearing range and eardrum capacity
• tympanometry, in which your doctor inserts a tympanometer into your ear to test your eardrum’s response to pressure changes

Your doctor may refer you to an ear, nose, and throat specialist, or ENT, if you need more specialized examinations or treatment for a ruptured eardrum.

TREATMENT
Treatment for eardrum rupture
Treatments for eardrum rupture are mainly designed to relieve pain and eliminate or prevent infection.

Patching

If your ear does not heal on its own, your doctor may patch the eardrum. Patching involves placing a medicated paper patch over the tear in the membrane. The patch encourages the membrane to grow back together.

Antibiotics

Antibiotics can clear up infections that might have led to your eardrum rupture. They also protect you from developing new infections from the perforation. Your doctor may prescribe oral antibiotics or medicated eardrops. You may also be told to use both forms of medication.

Surgery

In rare cases, surgery may be required to patch the hole in the eardrum. A surgical repair of a perforated eardrum is called tympanoplasty. During tympanoplasty, your surgeon takes tissue from another area of your body and grafts it onto the hole in your eardrum.

Home remedies

At home, you can ease the pain of a ruptured eardrum with heat and pain relievers. Placing a warm, dry compress on your ear several times daily can help.
Promote healing by not blowing your nose any more than absolutely necessary. Blowing your nose creates pressure in your ears. Trying to clear your ears by holding your breath, blocking your nose, and blowing also creates high pressure in your ears. The increased pressure can be painful and slow your eardrum’s healing.
Don’t use any over-the-counter eardrops unless your doctor recommends them. If your eardrum is ruptured, fluid from these drops can get deep into your ear. This can cause further issues.

IN CHILDREN
Eardrum ruptures in children
Eardrum ruptures can happen much more frequently in children because of their sensitive tissue and narrow ear canals. Using a cotton swab too forcefully can easily damage a child’s eardrum. Any kind of small foreign object, such as a pencil or hairpin, can also damage or rupture their eardrum if inserted too far into their ear canal.
Ear infections are the most common cause of eardrum ruptures in children. Five out of 6 children have at least one ear infection by the time they’re 3 years old. Your child’s risk of infection can be higher if they spend time in a group day care or if they bottle-feed while lying down instead of breast-feed.
See your child’s doctor right away if you notice any of the following symptoms:

• mild to severe pain
• bloody or pus-filled discharge leaking from the ear
• nausea, vomiting, or consistent dizziness
• ringing in the ears

Take your child to an ENT specialist if your doctor is concerned that your child’s ruptured eardrum needs additional care.
Because your child’s eardrums are delicate, untreated damage can have long-term effects on their hearing. Teach your child not to stick objects in their ear. In addition, try to avoid flying with your child if they have a cold or a sinus infection. The pressure changes could damage their eardrums.

RECOVERY
Recovery from eardrum rupture
A ruptured eardrum often heals without any invasive treatment. Most people with ruptured eardrums experience only temporary hearing loss. Even without treatment, your eardrum should heal in a few weeks.
You’ll usually be able to leave the hospital within one to two days of an eardrum surgery. Full recovery, especially after treatment or surgical procedures, typically occurs within eight weeks.

PREVENTION
Prevention of future ruptures
There are multiple things that you can do to prevent future eardrum ruptures.

Prevention tips

• Keep your ear dry to prevent further infection.
• Gently stuff your ears with cotton when you bathe to prevent water from entering the ear canal.
• Avoid swimming until your ear heals.
• If you get an ear infection, get it treated right away.
• Try to avoid flying in airplanes when you have a cold or sinus infection.
• Use earplugs, chew gum, or force a yawn to keep your ear pressure stabilized.
• Don’t use foreign objects to clean out extra earwax (showering every day is usually enough to keep your earwax levels balanced).
• Wear earplugs when you know that you’ll be exposed to a lot of noise, such as around loud machines or at concerts and construction sites.

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