How to tell if your eardrum is ruptured

A perforated eardrum is a tear or hole in the ear's tympanic membrane (the eardrum). A perforated eardrum is also called a ruptured eardrum.

A perforated (PER-fer-ate-id) eardrum can hurt, but most heal in a few days to weeks. If they don't heal, sometimes doctors do a surgery to fix the hole.

What Does the Eardrum Do?

The eardrum is a thin piece of skin-like tissue that's stretched tight — like a drum — across the opening between the ear canal and the middle ear.

The outer ear funnels sound waves into the ear canal that hit the eardrum and make it vibrate. The middle ear and inner ear change the vibrations to signals that the brain senses as sounds.

A ruptured eardrum can't vibrate as well as it should. This can cause a hearing problem, which often is temporary.

What Causes a Perforated Eardrum?

Many things can tear an eardrum, such as:

• Using cotton swabs. Sticking anything into the ears raises the risk of infection or damage to the ear canal or eardrum. Cotton swabs are handy for grooming needs, but should not be used to clean the ears or remove earwax.
• Sudden pressure changes (barotraumas). Most of the time, the air pressure in the middle ear and the pressure in the environment are in balance. But things like flying in an airplane, driving on a mountain road, or scuba diving can cause a sudden change in pressure that can rupture an eardrum.
• Loud noises (acoustic trauma). Very loud noises, like an explosion, can create sound waves strong enough to damage the eardrum. Loud noise also can cause temporary or permanent damage to the cochlea.
• Head trauma. A direct blow to the ear or a severe head injury from something like a car crash can fracture (break) the skull bone and tear the eardrum.
• Direct trauma to the pinna and outer ear canal. A slap on the ear with an open hand or other things that put pressure on the ear can tear the eardrum.
• Ear infections. An infection of the middle ear or inner ear can cause pus or fluid buildup behind the eardrum. This can make the eardrum burst open.

What Are the Signs & Symptoms of a Perforated Eardrum?

The typical first sign of a perforated eardrum is pain. A child might have:

• mild to severe pain that may get worse for a time before suddenly decreasing
• drainage from the ear that can be clear, pus-filled, or bloody
• hearing loss
• ringing or buzzing in the ear (tinnitus)
• dizziness or vertigo (a feeling that the room is spinning)
• rarely, weak facial muscles

Call the doctor right away if your child has any symptoms of a perforated eardrum. Even though most perforations heal on their own, it's important to make sure any hearing loss is temporary.

Go to the emergency room right away if your child has:

• bloody discharge from the ear
• extreme pain
• total hearing loss in one ear
• dizziness that causes vomiting

How Is a Perforated Eardrum Diagnosed?

To check for a perforated eardrum, doctors check the ear canal with a lighted instrument called an otoscope. Often, a doctor can see the tear and sometimes the tiny bones of the middle ear. In some cases, fluid draining from the ear can make it hard to see the eardrum.

You may have come across the term ‘perforated eardrum’. Did you know the term refers to the condition of a ruptured eardrum? Although it is rare, this condition can also possibly lead to a permanent loss of hearing.

When sound waves enter your ears, the first activity is a vibration in the tympanic  membrane, which continues through the bones of your middle ear. This vibration amplifies sound, so if the eardrum suffers any damage, you can see how it may affect your ability to hear.

When it is not too severe, the ruptured eardrum generally heals within a couple of weeks without needing any treatment. However, if the rupture is more severe, then it may require surgical treatment to heal.

What are the causes of eardrum rupture?

Causes of Eardrum Rupture

There are several causes of eardrum rupture. Let us look at them below:

1. Trauma or Injury
   One primary reason for a ruptured eardrum is an injury to the ear or even the side of your head. Injuries can occur in a number of circumstances, including car accidents, falling and hitting your head or your ear, while engaging in sports, or getting hit on your ear.
   You can also damage or injure your eardrum when you insert an object in your ear, such as a pen, a bobby pin, a feather, a cotton swab, and even a fingernail, etc. Injuries to your eardrum can also occur from acoustic trauma, which includes extremely loud sounds. This, however, is a very rare circumstance.
2. Changes in Pressure
   Barotrauma is the term we use when a perforated eardrum occurs due to changes in pressure. Certain activities could cause this condition but it mainly features a drastic variation between the pressure outside your ear from the pressure inside.
   This condition is generally the result of extreme conditions such as shock waves, flying in an aircraft with extreme and sudden changes in altitude, forceful and direct impact on your ear, driving at a high altitude, or going scuba diving.
3. Ear Infections
   Ear infections are not only a common occurrence among children and adults, they are also usually the primary causes of eardrum rupture. In an ear infection, fluids can accumulate behind your eardrum and create pressure from the buildup. Under this pressure, your tympanic membrane can rupture or break.
4. Head Injury
   Sustaining a severe head injury, such as a fracture of your skull base can also damage or dislocate your inner and outer ear structure. This may also cause your eardrum to break.

Ruptured Eardrum Symptoms

To verify if you are suffering from a ruptured eardrum, you must take note of the following ruptured eardrum symptoms.

• Varying Degrees of Pain
  The main and most common symptom of eardrum rupture is pain. People can experience varying degrees of pain with eardrum rupture. Sometime the pain may remain steady throughout the day while for some the severity may fluctuate, increasing, or decreasing over time.

• Drainage
  You may experience pus-filled, bloody, or watery fluids oozing out of your affected ear.

• Loss of Hearing
  A ruptured eardrum may result in hearing loss. The level of hearing loss depends on the size of the perforation and what caused it.

Other symptoms of a ruptured eardrum include:

• Vomiting or Nausea Resulting from Vertigo
• Spinning Sensation
• Tinnitus – Ringing in the Ears
  Tinnitus may occur as a result of a ruptured eardrum, which is a buzzing, ringing or whooshing sound in your ears with no external cause.

Diagnosing a Ruptured Eardrum

When you consult a doctor for help with your ruptured eardrum, they may diagnose it in any of the following ways:

• Your doctor may use the tympanometry method. This method includes inserting a small probe into your ear to test the response of the eardrum to changes in pressure.
• You may have to undergo an audiology exam where the doctor checks your capacity to hear.
• The doctor may examine your ears with an otoscope, which is a special device to help visualize the condition of your ear canal and eardrum.
• The doctor may also take a fluid sample from the fluid oozing out of your ear and test it to check for an infection that may be the cause of the ruptured eardrum.

In case you require more extensive treatment options or specialized examinations, you may have to consult an ENT doctor (i.e. Ear, Nose and Throat specialist).

Treatment Options

If you are suffering from a ruptured eardrum, you may want to know how to treat it. Most treatment options generally aim to relieve the pain and keep infections from occurring. The treatment options for ruptured eardrum are:

• Surgery
  Surgery for a perforated eardrum is required only in rare cases. We refer to the surgical repair of the ruptured eardrum as tympanoplasty. During this surgery, the surgeon takes a graft from an alternate part of your body to graft into the hole or gap present in your eardrum.
• Antibiotics
  Antibiotics work to heal the infection that may be the cause of the rupture, and prevent other infections from starting from the perforation. In mild cases, your doctor may prescribe antibiotics in the form of medicated ear drops or oral medicine. In advanced cases, the doctor may prescribe both forms to heal the rupture.
• Patching
  A normal ear rupture generally heals on its own, but if it doesn’t, your doctor may have to patch your eardrum. In this instance, the doctor uses a medicated paper to place over the tear in your membrane. This patch works as a support for your membrane to grow again.

Complications Can Arise From Your Ruptured Eardrum

To understand what complications can arise in case your eardrum ruptures, you need to understand the primary roles of your tympanic membrane. The tympanic membrane does the following:

• Protection:
  The eardrum, or tympanic membrane, acts as a shield for your middle ear against bacteria, water, and other substances.
• Hearing:
  Your inner and middle ear structures convert the sound waves into nerve impulses as the first step to hearing. This happens when the sound waves strike your eardrum and it vibrates.

Possible complications may arise in the event your ruptured eardrum fails to heal within three to six months:

• Cholesteatoma or Middle Ear Cyst can occur when you have suffered a long-term ruptured eardrum. The cyst is composed of skin cells and other accumulated debris in your middle ear.
• Chronic Infections and Drainage:
  A perforated eardrum is a welcome space for bacteria to enter. Many people can experience several chronic or ongoing infections if the ruptured eardrum fails to heal. Some can even suffer hearing loss or chronic drainage as a result.

Prevent Eardrum Ruptures

Ruptured eardrums are not necessarily the result of human error, but sometimes we can take certain measures to prevent our eardrums from suffering damage. Here is what you can do to prevent eardrum rupturing:

• Never put foreign objects in your ears, such as bobby pins, paper clips, feathers, cotton swabs, etc. You must never resort to such objects even if it is to dig out earwax. It takes only one fatal prick by these objects to tear up or puncture your eardrum. You must also teach your children from a very young age about the dangers of putting objects in their ears. Even the nail of your smallest finger can be extremely harmful to the delicate tympanic membrane.
• Try to avoid activities where you know loud sounds and noises will be inevitable. In case you cannot escape work commitments or events and activities that include explosive noises, you must protect your ears with earmuffs or earplugs to avoid unnecessary damage.
• Avoid flying in an airplane if you are suffering from a cold, congestion, or an active allergy. If you can’t avoid flying, use pressure-equalizing ear plugs to equalize the pressure in your ears during takeoff and landing. Chewing gum and yawning can also help to reduce pressure in the ears.
• Stay attuned to any symptoms and signs of a middle ear infection. These include reduced hearing, nasal congestion, fever, and earaches. In the case of children, in addition to ear pain, you may even consider a loss of appetite, refusal to eat, and fussiness as potential signs of a middle ear infection. In this case, seek the help of your primary care physician to check for an ear infection and avoid potential damage to the eardrum.

Full Recovery With Early Expert Diagnosis and Care

A ruptured eardrum is an easily treatable condition and you can expect a full recovery within a short time, provided you seek treatment promptly. Many people have been able to avoid potential damage to their ears by seeking a consultation in the earliest stage and availing the right treatment. With the right experts and the right course of treatment, your eardrum will be able to perform at maximum potential again.

Hearing Doctors

Hearing Doctors diagnoses ear-related problems, including ruptured eardrums, hearing loss, and tinnitus. We specialize in treating hearing loss and tinnitus, and provide custom hearing protection solutions. Medical issues such as eardrum ruptures are referred to an ENT specialist.

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