Perforated ear drum
- A perforated ear drum or hole or rupture in the eardrum is a hole in the thin membrane that separates the ear canal and the middle ear
- This is called a perforated eardrum or ruptured ear drum
- The medical term for eardrum is tympanic membrane
- The middle ear is connected to the nose by the passage called Eustachian tube, which equalizes pressure in the middle ear
- A perforated eardrum is often accompanied by decreased hearing and occasional discharge – pain is usually not persistent
What causes eardrum perforation?
- The causes of a perforated eardrum are usually from trauma or infection
- A perforated eardrum from trauma can occur:
- If the ear is struck directly
- With a skull fracture
- After a sudden explosion
- If an object (such as a bobby pin, cotton bud, or stick) is pushed too far into the ear canal
- As a result a foreign body entering the ear canal
Middle ear infection – otitis media
- Middle ear infections may cause pain, hearing loss, and rupture (tear) of the eardrum, resulting in a perforation
- In this circumstance, there may be infected drainage from the ear
- In medical terms, this is called otitis media with perforation
- Symptoms of acute otitis media may include:
- A sense of fullness in the ear
- Diminished hearing
- Ear pain
- Fever
How is hearing affected by a perforated eardrum?
- Usually the size of the perforation determines the level of hearing loss – a larger hole will cause greater hearing loss than a smaller hole
- The location of the perforation also affects the degree of hearing loss
- If severe trauma (e.g., skull fracture) dislocates the bones in the middle ear which transmit sound, or injures the inner ear structures, hearing loss may be severe
- If the perforated eardrum is caused by a sudden traumatic or explosive event, the loss of hearing can be great and tinnitus (ringing in the ear) may be severe
- In this case, hearing usually returns partially, and the ringing diminishes in a few days
- Chronic infection as a result of the perforation can cause persistent or progressive hearing loss
Perforated ear drum management issues
- Before attempting any correction of the perforation, a hearing test should be performed
- The benefits of closing a perforation include prevention of water entering the ear while showering, bathing, or swimming (which could cause ear infection), improved hearing, and diminished tinnitus
- It also may prevent the development of cholesteatoma (skin cyst in the middle ear), which can cause chronic infection and destruction of ear structures
Perforated eardrum treatment
- If the perforation is very small, an otolaryngologist may choose to observe the perforation over time to see if it will close spontaneously
- Eardrum perforations may heal on their own within weeks of rupture, although some may take several months to heal
- During the healing process the ear must be protected from water and trauma
- Eardrum perforations that do not heal on their own may require surgery
- There are a variety of surgical techniques, but most involve grafting tissue across the perforation to allow healing
- The name of this procedure is called tympanoplasty
- Surgery is typically quite successful in repairing the perforation, restoring or improving hearing, and is often done on an day surgery basis
- Your ENT surgeon will advise you regarding the proper management of a perforated eardrum