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Perforated Eardrum - Causes, Symptoms, Diagnosis and Treatment

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Perforated eardrum or ruptured eardrum is the tear or hole in the tympanic membrane (eardrum) that separates the ear canal from the middle ear.

Medically reviewed by

Dr. Akshay. B. K.

Published At August 18, 2022
Reviewed AtFebruary 20, 2024

What Is a Perforated Eardrum?

The perforated eardrum is a tear or hole in the eardrum, also known as the tympanic membrane. This tympanic membrane is a skin-like structure that separates the ear canal, a part of the external ear, from the middle ear. The eardrum converts the sound waves into vibrations, which are then transferred to other parts of the ear. The ruptured eardrum is most commonly seen in children and is commonly caused by ear infections. This may cause temporary hearing loss and will heal within two months. A ruptured eardrum can also be caused by loud noises or by poking the eardrum with any sharp objects. Rarely does this condition cause any complications.

What Effects Does a Perforated Eardrum Have on the Body?

The eardrum is one of the components of the auditory system. The outer ear receives the sound, and it helps to produce vibration in the eardrum. The auditory nerve receives the signal produced by the vibration, and the nerve conducts the signal to the brain. If the eardrum is perforated, the signal will not be produced. The eardrum helps to guard the middle ear from foreign objects, including water, germs, and skin cells. Microorganisms can enter through the perforated eardrum more easily, resulting in ear infections. Occasionally, a middle ear cyst may develop if skin cells enter the middle ear.

What Are the Causes of Perforated Eardrum?

A perforated eardrum can be caused by the following reasons:

  • Ear Infections: Ear infections can cause a ruptured eardrum and are the most common cause in children. The ear infection will result in fluid or pus build-up behind the eardrum. This accumulated fluid exerts pressure on the eardrum. When this pressure exceeds a certain limit, this will result in the perforation of the eardrum.

  • Loud Noises: Loud noises or sounds from blasts or gun fires can cause a perforated eardrum. But this can rarely cause this condition.

  • Foreign Objects: When things such as cotton swabs, hairpins, or safety pins are introduced into the ear, they can rupture the eardrum.

  • Pressure Changes: When there is a pressure difference between the middle ear and the external environment, this exerts pressure on the eardrum and causes this condition.

  • Injury to the Head: Sudden injury to the side of the head can result in a tear in the eardrum.

What Are the Symptoms of Perforated Eardrum?

The symptoms of the perforated eardrum are as follows:

  • Pain in the ear that subsides quickly.

  • Discomfort in the ear.

  • Drainage from the ear that could be clear, pus, or bloody.

  • Hearing loss.

  • Tinnitus (ringing sound in the ear).

  • Vertigo (spinning sensation).

What Steps Should Be Taken if the Eardrum Is Perforated?

Individuals can follow the below-mentioned steps to reduce symptoms and boost the healing process.

Do’s:

  • Individuals can take over-the-counter painkillers to reduce pain.

  • While washing the hair, individuals can plugin cotton wrapped with petroleum jelly in the outer ear to prevent water from entering the inner ear.

Don'ts:

  • Avoid swimming or any other actions that cause the inner eat to get wet.

  • Avoid putting anything in the ears, including cotton buds or ear drops.

  • Avoid blowing the nose since it may impact the healing process.

How to Diagnose Perforated Eardrum?

The ENT specialist will diagnose the perforated eardrum by taking a detailed case history, and following that, a detailed examination will be carried out and may also suggest certain tests. A visual examination is carried out using an otoscope. An otoscope is an instrument fitted with light and used to visualize the ear canal and eardrum.

The following tests are carried out to arrive at a diagnosis:

  • Laboratory Tests: When there is a discharge from the ear, a doctor may suggest a laboratory test or culture test to diagnose any bacterial infection of the ear.

  • Tuning Fork Test: A tuning fork is a metal instrument struck against a surface and vibrating. This instrument is used to test hearing loss. The test can also reveal what type of hearing loss and whether hearing loss is caused by damage to the vibrating part of the ear or the sensor or nerve of the ear, or both.

  • Tympanometry: Tympanometry is a device that is used to detect the ears' response to changes in pressure. The patterns of response to change in pressure can indicate a perforated eardrum.

  • Hearing Test: This test analyzes how well one can hear at different volumes and pitches. These tests are carried out in a soundproof booth.

How Is Perforated Eardrum Treated?

The perforated eardrum usually heals itself within a few weeks' time and does not require any specific treatment for it as such. In some cases, the doctor would advise the following treatment:

  • Antibiotics: Antibiotics will be prescribed in case any infection occurs in the ear. The antibiotic could be in the form of eardrops or as an oral medication.

In case the hole or the tear in the eardrum does not heal on its own, then treatment to close the hole is carried out, such as:

  • Myringoplasty: In this procedure, the tear is sealed by placing a gel-like material or using a special paper. The duration of the procedure could be between ten minutes to 30 minutes.

What Are the Complications of Perforated Eardrum?

If the perforated eardrum persists for a longer duration, the following possible complications can happen and are discussed as follows:

  • Otitis Media - Also known as the middle ear infection, can be caused by the bacteria which enter the middle ear from the perforated part of the eardrum. This can cause ongoing and recurrent infections in such people.

  • Cholesteatoma - Also known as the middle ear cyst, develops in the middle ear as a result of a long-standing perforated eardrum. As a result of this cyst formed in the middle ear, bacteria can club in and damage the bones in the middle ear.

  • Hearing Loss - Even though it is a temporary condition caused by the perforated eardrum, the intensity and duration will depend upon the size and the location of the tear.

What Precautions Need to Be Taken When Someone Has Perforated Eardrum?

The ruptured eardrum usually heals on its own and may take some time to heal; it may even take months for the hole to heal. In such cases, certain things need to be kept in mind to avoid any complications to the already existing condition, such as:

  • Keep the Ear Dry - While bathing, take measures to avoid water entering the ear, like placing silicone earplugs or cotton balls in the ear.

  • Avoid Cleaning the Ear - Avoid introducing things into the ear to clean the ear and give appropriate time for the wound to heal.

  • Refrain From Blowing the Nose - When one blows the nose, pressure is exerted on the eardrum; this can worsen the already existing condition.

When to Visit a Physician?

When individuals experience any of the signs and symptoms of perforated eardrum, contact the physician right away. The fragile tissues that compose the middle and inner ears are vulnerable to damage or illness. Determining whether an eardrum rupture has taken place and trying to identify the origin of the symptoms is critical.

Conclusion

A perforated eardrum is a condition in which there is a tear or hole in the eardrum that could be caused by either an infection, loud noises, or a foreign body introduced into the ear. The symptoms could be from pain to hearing loss. This condition usually heals on its own, even though it might take a few weeks to months or, in some cases, might require special treatments. However, it is always advised to consult a doctor in case a perforated eardrum is suspected.

Dr. Akshay. B. K.
Dr. Akshay. B. K.

Otolaryngology (E.N.T)

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ruptured eardrumhearing loss
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