Understanding Perforated Eardrums: Causes, Prevention, Indicators and Treatment Methods

Eardrums are very important, serving two extremely important roles in hearing. First of all they vibrate when sound hits them. Second they create a barrier that safeguards the inner ear from infection. While intact, the eardrum seals off the inner ear setting up a sterile and clean environment. If the ear drum is punctured, the inner ear is left susceptible to infection.

The terms perforated eardrum and ruptured eardrum are essentially the same. They both describe a problem whose technical name is a tympanic membrane perforation where there is a puncture or tear in the very thin membrane we know as the ear drum. There are numerous causes of punctured eardrums. The most common is an inner ear infection. Fluid at the site of the infection presses up against the eardrum membrane, building up pressure until it finally rips. Many people perforate their own eardrums by poking foreign objects into the ears, such as the use of cotton swabs to eliminate ear wax. Barotrauma is another potential cause of a punctured ear drum. When the pressure outside the ear is very different than the pressure inside the ear (lower or higher) the eardrum may not be capable of withstanding the pressure difference and ruptures. Scuba diving and flying are a couple of occasions in which this is prone to occur. Loud noises and explosions may also cause punctured ear drums. This phenomenon is known as acoustic trauma.

The signs of a perforated eardrum include ear pain, fluid draining from the ear, partial or complete hearing loss in the affected ear, tinnitus (ringing in the ears), and vertigo or dizziness. If you experience any of these signs and symptoms, see a specialist, because if the eardrum is ruptured, immediate and correct treatment is important to avoid infection and hearing damage. What you risk by not having these symptoms treated are serious inner ear infections and cysts, and the chance of permanent loss of hearing.

Perforated eardrums are diagnosed in a doctor’s office using an instrument called an otoscope, which has an internal light which allows the doctor to see the eardrum clearly. Perforated eardrums typically heal on their own in 2-3 months. During this time period, your specialist will probably counsel you to avoid swimming and diving and to refrain from blowing your nose if possible. It’s also advisable to avoid any extraneous medications. For rips along the edges of the eardrum, the specialist may choose to put in a temporary patch or dam which helps prevent infection. In very rare cases, surgical treatment may be advised.

Your health care provider may also recommend over-the-counter pain medications such as acetaminophen or ibuprofen to deal with pain. The key safety measures you can take to prevent this condition are to 1) refrain from inserting any foreign objects into your ear canal, even to clean them, and 2) deal with ear infections without delay by visiting a specialist.