What Does an Eardrum Do?
The eardrum has two main roles:
- Hearing – Your eardrum vibrates from sound waves striking it. In turn, structures in your middle and inner ear translate sound waves into nerve impulses.
- Protection – Acting as a barrier, your eardrum protects your middle ear from water, bacteria, and foreign substances.
What is an Eardrum Perforation?
An eardrum perforation is defined as a hole or rupture in the eardrum. Known medically as a tympanic membrane rupture, this tear occurs in the membrane separating your outer ear from your inner ear. A perforation can lead to a middle ear infection and possible hearing loss, though in many cases it will heal on its own without medical treatment.
How Does a Rupture Affect Eardrum Functions?
The eardrum converts sound waves into nerve impulses that are sent to the brain, and protects the middle ear from bacteria, moisture and other foreign objects. A perforation can disrupt both important functions.
When an eardrum is ruptured it can allow bacteria to enter the ear and cause an ear infection (otitis media). A rupture or perforation can also create a hole; just like a drumhead is worse at carrying sound with a hole in it, your tympanic membrane is too. This is the reason a rupture can contribute to a loss of hearing.
What Can Cause Eardrum Perforations?
Eardrum perforations are most often caused by:
Infection. Middle ear infections cause a buildup of pressure that may result in a ruptured eardrum.
Injury. Injury or trauma to the ear and head like a sudden loud noise or skull fracture can cause an eardrum to rupture.
Eustachian tube disorders. Inserting objects such as bobby pins or Q-tips in the ear to clean wax can cause an accidental rupture. Chronic Eustachian tube problems can weaken the eardrum, making it more prone to perforation.
What Are the Symptoms of a Perforated Eardrum?
Some people are completely unaware of a ruptured eardrum; there may be a complete lack of symptoms or only a feeling of general discomfort. Other times, people will experience:
- A sudden sharp pain in the ear
- A discharge of fluid that may be bloody, clear or pus-like
- A buzzing or ringing in the ear
- Partial or complete hearing loss in the affected ear
- Ear infection
- Facial weakness or dizziness
Are There Any Possible Complications?
If your perforated eardrum does not self-heal in three to six months and you don’t seek treatment, possible complications include:
Temporary Hearing Loss
Hearing Loss due to a perforated eardrum is usually temporary. Size and location of the perforation plays a huge role in the eardrum’s healing process, resulting in the degree of hearing loss you may experience.
Middle Ear Infection (otitis media)
A perforated eardrum can allow bacteria to enter the ear. If the perforation doesn’t heal, a small number of people are subject to recurrent ear infections.
Middle Ear Cyst (cholesteatoma)
This cyst, composed of skin cells and various debris, is very rare. The cyst is a result from a long-term development in the middle ear after your eardrum has been perforated.
How Are Eardrum Perforations Diagnosed?
A doctor will examine your ears with an otoscope to visually identify a hole or tear in the eardrum. A hearing test may be required.
If your physician can’t see the rupture but suspects you have one they may use a process called tympanometry to create pressure variations in your middle ear. A perorated tympanic membrane produces a flat test response and typically cause a conductive hearing loss.
How is an Eardrum Perforation Treated?
Because the majority of perforated eardrums heal on their own in a few months, no treatment may be needed other than antibiotics to prevent or treat infection. Nonprescription pain medication and a warm compress can help. Large perforations may require surgery.
While the rupture is healing you’ll need to keep the ear dry, avoiding water as much as possible.
How Long Does a Perforated Eardrum Take to Heal?
An eardrum perforation can self-heal after three to six months. If complications arise, it may take longer for the eardrum to heal.