The eardrum, also called the tympanic membrane, is the thin tissue separating the ear canal from the middle ear. A ruptured eardrum is a tear in this tissue. It is also called a perforated eardrum or tympanic membrane perforation.
A person with a ruptured eardrum may experience the following:
- severe earache, which may suddenly go away
- loss of hearing in the affected ear
- drainage from the ear that may contain blood
- buzzing or ringing in the ear
- a blocked feeling in the ear
- dizziness or loss of balance
- a whistling sound through the ear when blowing the nose
In people who experience a loss of hearing, the extent of this loss may depend on the size of the hole in the eardrum.
A ruptured eardrum can occur as a result of several different causes:
Either a severe ear infection or repeated mild infections can cause the eardrum to rupture.
An infection of the middle ear, which is called acute otitis media, happens when bacteria or viruses cause fluid to build up in the middle ear.
When fluid or pus accumulates behind the eardrum, the pressure can cause the eardrum to tear.
Ear infections can be very painful and may sometimes cause hearing difficulties.
Direct trauma can cause the eardrum to rupture. The ear tissue is a thin layer that can easily tear if a person sustains blows from various activities, including sports.
Severe trauma to the ear or a head injury can sometimes damage both the inner and middle ear.
Inserting an object, such as a cotton swab, pencil, or bobby pin, into the ear can rupture the eardrum.
It is possible for children to insert objects into their ear accidentally. People should avoid inserting anything into their ear if possible.
An explosion or extremely loud noise close to the ear can cause the eardrum to rupture. It is possible for this to occur in musicians and those listening to music at a high volume.
If changes in air or water pressure damage the ear, this is called ear barotrauma. It can happen when there is a difference in pressure between the inner and outer ear.
The eustachian tube connects the middle ear to the back of the nose and throat, and it equalizes the pressure on either side of the eardrum. If this tube cannot open due to extreme changes in pressure, the unequal pressure can rupture the eardrum.
Scuba diving and air travel are common causes of ear barotrauma. Scuba diving can increase pressure on the ear, which can cause the eardrum to rupture, particularly when a person is descending.
A change in pressure can cause a vacuum in the middle ear to pull the eardrum inward and may eventually cause it to rupture.
Air travel can change the pressure between the outer and middle ear. This increase in pressure can cause the eardrum to stretch and, in some cases, tear.
People should see their doctor if they think that they have a ruptured eardrum.
A doctor will use an instrument called an otoscope to examine inside the ear. Doing this will allow them to see if there is a hole in the eardrum and to determine its size.
The doctor may also carry out a hearing or balance test. They may blow air into the ear to test pressure.
A ruptured eardrum will often heal by itself within 1 to 3 months. People can take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to relieve earache and reduce any inflammation. If people have an earache, a warm compress on the ear can help relieve mild pain.
A doctor may prescribe oral antibiotics or antibiotic eardrops for people who have an ear infection.
If the eardrum does not heal by itself, a surgical procedure called tympanoplasty may be necessary to repair the hole.
It is important to keep the ear dry while recovering from a ruptured eardrum to avoid getting a middle ear infection.
Wearing watertight earplugs or a cotton wool ball with a coating of petroleum jelly can help prevent water from entering the ear while showering. It is best to avoid swimming and other water-based activities until the eardrum heals.
A person should also try not to blow the nose. If necessary, they can exhale very gently through one nostril at a time to prevent changes of pressure in the ear that can delay healing.
People should avoid inserting any objects into their ear, even to clean the ear, to prevent damage to the eardrum.
If people have an ear infection, they should receive treatment as soon as possible to prevent it from worsening or resulting in a ruptured eardrum. Certain vaccinations, such as the flu jab or pneumococcal vaccination, can also lower the risk of getting ear infections in the first place.
According to the Centers for Disease Control and Prevention (CDC), exclusively breastfeeding a baby until the age of 6 months and then continuing breastfeeding for 12 months can help lower their risk of infections, including ear infections.
Avoiding smoking or secondhand smoke can also reduce a person's risk of getting ear infections.
The eustachian tubes must remain open so that a change in air or water pressure does not cause ear barotrauma.
To help keep them open and relieve pressure on the eardrum when flying, people can try the following:
- swallowing frequently
- chewing gum or sucking on a hard candy
- yawning or opening the mouth wide
- blocking the nostrils with the thumb and forefinger and gently breathing out through a closed mouth
- using special earplugs that manufacturers have designed for flying
People flying with a cold or a stuffy nose may find that taking a decongestant before the flight helps keep the airways more open.
When scuba diving, people can usually equalize their ears by descending slowly and avoiding diving with a cold or symptoms of an allergy. Anyone attempting scuba diving should always follow the advice of a professional.
People with ear barotrauma should not fly or dive again until their doctor confirms that it is safe to do so. Anyone who experiences frequent barotrauma of the ear may need a doctor to insert a ventilation tube into their eardrum to keep the eustachian tubes open.
People can protect their ears from loud noises by wearing earplugs, earmuffs, or other ear protection when in a noisy setting, such as a music concert, building site, or shooting range.
Anyone at risk of blows to the ear from sports should also consider wearing ear protection during these activities.
A ruptured eardrum will often heal by itself within a few months.
It is important to keep the ear dry until the eardrum heals to prevent infection. If a person continues to experience symptoms of a ruptured eardrum, they should see their doctor.
In cases where the eardrum does not heal by itself, a surgical procedure may be necessary to repair the torn eardrum.