Perforated Eardrum

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What is a perforated eardrum?

A perforated eardrum is a rupture or a tear in the tympanic membrane, which is located between your outer ear and middle ear. Better known as the eardrum, the tympanic membrane vibrates in response to sound waves entering the ear. Nerve cells in the middle and inner ear transmit signals to the brain, which the brain perceives as sound.

If your eardrum ruptures, you may experience acute pain accompanied by leakage of pus (if an infection is present) and blood. Your hearing may be muffled or otherwise impaired. A perforated eardrum may be caused by an infection that leads to an accumulation of fluids or pus in your middle or inner ear. Your ear may continue to swell and the eardrum may burst upon experiencing pressure.

Sudden, dramatic shifts in air pressure, such as those experienced when flying in an airplane or scuba diving, can also cause your eardrum to burst. This is known as barotrauma and occurs from extreme pressure differences between the inside of your ear and the outside. Loud noises, such as from jackhammers and construction, fireworks, gunshots, or loud music, can cause a perforated eardrum. Sticking foreign objects in your ear can also rupture the eardrum.

Seek immediate medical care (call 911) if you have ruptured your eardrum and experience bleeding, pus leakage, and hearing loss. You should also seek immediate medical attention if the perforation is accompanied by flu-like symptoms, including fatigue, fever, sore throat, headache, cough, aches, and pains.

A ruptured eardrum that continues to produce symptoms despite treatment should be evaluated. Seek prompt medical care if you are being treated for a perforated eardrum but continue to experience symptoms for two months or longer.

What are the symptoms of a perforated eardrum?

Symptoms of a perforated eardrum primarily occur in the ear but may be present in other body systems as well. You may feel immediate pain, discomfort and buzzing in the ear; pain in the face; and dizziness.

Common symptoms of a perforated eardrum

Symptoms of perforated eardrum include:

  • Audible whistling from the ear during nose-blowing
  • Dizziness
  • Ear pain
  • Facial pain or weakness
  • Loss of hearing
  • Pus or blood leaking from the ear
  • Ringing or buzzing in the ear (tinnitus)

Symptoms that might indicate a serious condition

In some cases, a perforated eardrum can be a serious condition that should be evaluated immediately in an emergency setting. Seek immediate medical care if you, or someone you are with, have any of these serious symptoms including:

  • Bleeding or other discharge from the ear

  • Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches, and pains)

  • Hearing loss

  • High fever (higher than 101 degrees Fahrenheit)

  • Ringing or buzzing in the ear (tinnitus)

  • Symptoms of perforated eardrum that persist after two months, despite medical treatment

What causes a perforated eardrum?

A perforated eardrum is a rupture or tear in the tympanic membrane, located between your outer ear and middle ear. It can be caused by an infection leading to the accumulation of fluids or pus in the middle or inner ear. The ear may continue to swell and the eardrum may burst upon experiencing pressure.

Sudden, dramatic shifts in air pressure, such as those experienced when flying in an airplane or scuba diving, can cause your eardrum to burst. This is known as barotrauma and occurs from extreme pressure differences between the inside of your ear and the outside. Loud noises, such as from jackhammers and construction, fireworks, gunshots, or loud music, can cause a perforated eardrum. Sticking foreign objects in your ear can also rupture the eardrum.

What are the risk factors for a perforated eardrum?

A number of factors increase the risk of developing a perforated eardrum. Not all people with risk factors will get perforated eardrum. Risk factors for perforated eardrum include:

  • Diving, flying, or other activities involving rapid pressure changes

  • Ear infections

  • Exposure to loud noises, such as drilling, hammering, fireworks or music

  • Inserting foreign objects, such as cotton swabs, into the ears

  • Previous ear surgery

Reducing your risk of a perforated eardrum

You can reduce your risk of perforated eardrum by avoiding or minimizing exposure to loud noises. Such activities as diving should be avoided if you are ill, and the proper precautions should always be taken. Perforated eardrum can occur as the result of infections, so it is important to take care of yourself when you are ill.

You may be able to lower your risk of perforated eardrum by:

  • Ascending and descending gradually when scuba diving

  • Avoiding or minimizing exposure to loud noises

  • Minimizing or avoiding air travel if you are ill or have a known ear infection

  • Seeking medical care when you are sick with the flu or have an infection

  • Wearing ear plugs, headphones, or other forms of ear protection when at a concert, construction site, or in other loud environments

How is a perforated eardrum treated?

Treatment for a perforated eardrum begins with seeking medical care from your health care provider. Antibiotics may be prescribed if there is an infection involved or as a preventive measure against future infection. Your health care provider may patch the ear to prevent bacteria from entering and to allow the eardrum to heal.

Analgesics, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), may be taken for the pain. You can also take such self-help measures as putting a warm heating pad over your ear. It is important to keep the area dry while you are showing or swimming to expedite the healing.

If significant time has passed and the eardrum is still not healing, surgery (tympanoplasty) may be required to restore the eardrum.

What you can do to improve your perforated eardrum

In addition to following the treatment steps your health care provider has outlined, you can take self-care measures at home that include:

  • Applying gentle external heat to your ear

  • Keeping your ears dry while they are healing

  • Taking over-the-counter pain medicines, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin)

What are the potential complications of a perforated eardrum?

You can help minimize your risk of complications by following the treatment plan that you and your health care professional design specifically for you. Left untreated, complications of a perforated eardrum include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 19
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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