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
