General Illness Information
Common Name: Perforated eardrum
Description: A hole in the thin membrane (tympanic membrane) that separates the inner ear from the outer ear.
Causes: The eardrum may be perforated when a sharp object is inserted in the ear, such as: a cotton swab or paper clip to clean the ear or relieve an itch; or by an object accidentally entering the ear, such as an unseen low-hanging twig on a tree or a thrown pencil. The eardrum may also be perforated by a sudden increase in inward pressure in the ear, such as with a slap; a swimming or diving accident; a nearby explosion. Other causes of a perforated eardrum are – a middle ear infection ; a sudden outward pressure or suction, such as with a kiss over the ear.
- Perforation of the eardrum can be prevented by avoiding trauma to the ears, and that is by not putting any objects into the ear canal, such as Q-tips, hair clips etc.
- The other precautions are – 1)avoiding injuries that may cause a rupture (see causes) and 2) obtaining prompt medical treatment for middle-ear infections.
Signs & Symptoms
- Sudden pain in the ear.
- Bleeding or pus discharge from the ear.
- Partial hearing loss.
- Ringing in the ear.
- Dizziness or vertigo.
- Occasionally, perforation causes relief to earache (in cases of ear infection).
- Recent middle-ear infection.
- Head injury.
Diagnosis & Treatment
Diagnosis is verified by otoscope examination of the ear. Also, culture of the fluid from the ear may be done.
- Treatment involves – medication to prevent or treat infection and supportive care for pain.
- Don’t blow your nose, if possible. If you must, blow gently.
- Keep the ear canal dry. Don’t swim, take showers or get caught in the rain
- Microsurgery (tympanoplasty) to repair the perforation if it doesn’t heal spontaneously. In most cases the eardrum heals spontaneously without further treatment. If it is not healed in 2 months, then tympanoplasty may be needed.
- If perforation of the eardrum is associated with persistent hearing loss and vertigo- then the patient should be hospitalized and be assessed by an otolaryngologist , as the patient may need emergency surgery.
- Antibiotics to prevent or treat infections.
- Pain relievers. For minor pain, you may use non-prescription drugs such as acetaminophen.
Resume your normal activities as soon as symptoms improve.
No special diet.
Possible Complications :
- Ear infection, with fever, vomiting and diarrhea.
- Significant blood loss (rare).
- Meningitis (rare).
- Mastoiditis (infection of the mastoid bone situated just behind the ear).
- Permanent hearing loss (rare).
If the ruptured eardrum does not become infected, it will usually repair itself in 2 months. If it becomes infected, the infection is curable with treatment, and hearing is usually not affected permanently.
If the perforation does not heal, surgery is needed.