An eardrum rupture is a small hole or tear in your eardrum,
or tympanic membrane. The tympanic membrane is a thin tissue that
divides your middle ear and outer ear canal.
This membrane vibrates when sound waves enter your ear. The
vibration continues through the bones of the middle ear. Because this vibration
allows you to hear, your hearing can suffer if your eardrum is damaged.
A ruptured eardrum is also called a perforated eardrum. In rare cases, this condition can cause permanent hearing loss.
Causes of eardrum rupture
Infection
Ear infections are a common cause of eardrum rupture,
especially in children. During an ear infection, fluids accumulate behind the
eardrum. The pressure from the fluid buildup can cause the tympanic
membrane to break or rupture.
Pressure changes
Other activities can cause pressure changes in the ear and
lead to a perforated eardrum. This is known as barotrauma, and it mainly
occurs when the pressure outside the ear is drastically different from the
pressure inside the ear. Activities that can cause barotrauma include:
Scuba diving
Flying in an airplane
Driving at high altitudes
Shock waves
Direct, forceful impact to the ear
Injury or trauma
Injuries can also rupture your eardrum. Any trauma to the
ear or side of the head can cause a rupture. The following have been known to
cause eardrum ruptures:
Getting hit in the ear
Sustaining an injury during sports
Falling on your ear
Car accidents
Inserting any kind of object, such as a cotton swab,
fingernail or pen, too far into the ear can harm your eardrum as well.
Acoustic trauma, or damage to the ear from extremely loud
noises, can rupture your eardrum. However, these cases are not as common.
Symptoms of eardrum rupture
Pain is the main symptom of eardrum rupture. For some, the
pain may be severe. It can remain steady throughout the day, or it can increase
or decrease in intensity.
Usually, the ear begins to drain once the pain goes away. At this
point, the eardrum is ruptured. Watery, bloody, or pus-filled fluids may drain
from the affected ear. A rupture that results from a middle ear infection
usually causes bleeding. These ear infections are more likely to happen in
young children, people with colds or the flu, or in areas with
poor air quality.
You may have some temporary hearing loss or a reduction in
hearing in the affected ear. You can also experience tinnitus, a constant
ringing or buzzing in the ears, or dizziness.
Diagnosing eardrum ruptures
Your doctor can use several ways to determine if you have a
ruptured eardrum:
A fluid sample, in which your doctor tests fluids that
may be leaking from your ear for infection (infection may have caused your
eardrum to rupture)
An otoscope exam, in which your doctor uses a
specialized device with a light to look into your ear canal
An audiology exam, in which your doctor tests your
hearing range and eardrum capacity
Tympanometry, in which your doctor inserts a tympanometer
into your ear to test your eardrum’s response to pressure changes
Your doctor may refer you to an ear, nose, and throat
specialist, or ENT, if you need more specialized examinations or treatment for
a ruptured eardrum.
Treatment for eardrum rupture
Treatments for eardrum rupture are mainly designed to
relieve pain and eliminate or prevent infection.
Patching
If your ear does not heal on its own, your doctor may patch
the eardrum. Patching involves placing a medicated paper patch over the tear in
the membrane. The patch encourages the membrane to grow back together.
Antibiotics
Antibiotics can clear up infections that might have led to
your eardrum rupture. They also protect you from developing new infections from
the perforation. Your doctor may prescribe oral antibiotics or medicated
eardrops. You may also be told to use both forms of medication.
Surgery
In rare cases, surgery may be required to patch the hole in the
eardrum. A surgical repair of a perforated eardrum is called tympanoplasty.
During tympanoplasty, your surgeon takes tissue from another area of your body
and grafts it onto the hole in your eardrum.
Home remedies
At home, you can ease the pain of a ruptured eardrum with
heat and pain relievers. Placing a warm, dry compress on your
ear several times daily can help.
Promote healing by not blowing your nose any more than
absolutely necessary. Blowing your nose creates pressure in your ears. Trying
to clear your ears by holding your breath, blocking your nose, and blowing also
creates high pressure in your ears. The increased pressure can be painful and
slow your eardrum’s healing.
Don't use any over-the-counter eardrops unless your doctor
recommends them. If your eardrum is ruptured, fluid from these drops can get
deep into your ear. This can cause further issues.
Eardrum ruptures in children
Eardrum ruptures can happen much more frequently in children
because of their sensitive tissue and narrow ear canals. Using a cotton swab
too forcefully can easily damage a child’s eardrum. Any kind of small foreign
object, such as a pencil or hairpin, can also damage or rupture their eardrum
if inserted too far into their ear canal.
Ear infections are the most common cause of eardrum
ruptures in children. Five out of 6 children have at least one ear
infection by the time they’re 3 years old. Your child’s risk of infection can
be higher if they spend time in a group daycare or if they bottle-feed while
lying down instead of breast-feeding.
See your child’s doctor right away if you notice any of the
following symptoms:
Mild to severe pain
Bloody or pus-filled discharge leaking from the ear
Nausea, vomiting, or consistent dizziness
Ringing in the ears
Take your child to an ENT specialist if your doctor is
concerned that your child’s ruptured eardrum needs additional care.
Because your child’s eardrums are delicate, untreated damage
can have long-term effects on their hearing. Teach your child not to stick
objects in their ear. In addition, try to avoid flying with your child if they
have a cold or a sinus infection. The pressure changes could
damage their eardrums.
Recovery from eardrum rupture
A ruptured eardrum often heals without any invasive
treatment. Most people with ruptured eardrums experience only temporary hearing
loss. Even without treatment, your eardrum should heal in a few weeks.
You’ll usually be able to leave the hospital within one to
two days of an eardrum surgery. Full recovery, especially after treatment or
surgical procedures, typically occurs within eight weeks.
Prevention of future ruptures
There are multiple things that you can do to prevent future
eardrum ruptures.
Prevention tips
Keep your ear dry to prevent further infection.
Gently stuff your ears with cotton when you bathe to prevent
water from entering the ear canal.
Avoid swimming until your ear heals.
If you get an ear infection, get it treated right away.
Try to avoid flying in airplanes when you have a cold or
sinus infection.
Use earplugs, chew gum or force a yawn to keep your ear
pressure stabilized.
Don’t use foreign objects to clean out extra earwax
(showering every day is usually enough to keep your earwax levels balanced).
Wear earplugs when you know that you’ll be exposed to a lot
of noise, such as around loud machines or at concerts and construction sites.
Outlook
Eardrum ruptures can be easily prevented if you protect your
hearing and avoid injury or putting objects in your ear. Many infections that
cause ruptures can be treated at home with rest and by protecting your ears.
However, see your doctor if you notice a discharge from your ear or you
experience severe ear pain for more than a few days. There are plenty of
successful diagnostic and treatment options for ruptured eardrums.
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