Definition

Tympanic membrane perforation, or a ruptured eardrum, is a hole in the eardrum (tympanic membrane).

The eardrum is a very thin membrane made of tissue that separates the middle ear from the ear canal. The eardrum aids in hearing and in preventing bacteria and other foreign matter from entering the middle ear.

Causes

Eardrums may rupture from a variety of causes, including:

• Ear infections
• Puncture from use of a cotton swab or other device inserted in the ear canal
• Damage to the ear, such as being slapped or hit
• Pressure building up inside the middle ear, as may occur with scuba diving

Risk Factors

Factors that may increase your chance of a ruptured eardrum include:

• Having an ear infection
• History of eardrum ruptures, or ear surgery, such as ear tubes
• Scuba diving
• Injury to the ear
• Inserting objects in the ear

Symptoms

You may not have any symptoms. For those that have symptoms, a ruptured eardrum may cause:

• Earache, severe and increasing in its severity
• Earache, severe, then subsides, then is followed by discharge from the ear
• Drainage from the ear—may have blood or pus
• Hearing loss or difficulty hearing out of the affected ear
• Buzzing or other noise in the ear

People who have traumatic ruptures to the eardrum may be at an increased risk of an ear infection. Infection may occur because the opening in the membrane allows bacteria to enter the middle ear and cause infection.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. During the exam, the doctor will examine the ear with an otoscope and look to see if the eardrum has been perforated. The perforation is sometimes difficult to see because of the thick drainage in the ear.

Doctors may also perform an audiology test to determine if any hearing loss has occurred.

Treatment

While many ruptured eardrums will heal on their own, many may also require treatment to heal properly. Talk with your doctor about the best treatment plan for you. Options may include:

Prevention

To help reduce your chance of a ruptured eardrum:

• Do not stick cotton swabs or other objects inside the ear
• Treat ear infections promptly and thoroughly
• Avoid scuba diving when you have cold or allergy symptoms

Family Doctor—American Academy of Family Physicians http://familydoctor.org

Health Canada http://www.hc-sc.gc.ca

Tympanic membrane perforation. Baylor College of Medicine website. Available at: https://www.bcm.edu/healthcare/care-centers/otolaryngology/conditions/tympanic-membrane-perforation. Accessed August 10, 2015.

Tympanic membrane perforation. Columbia University Medical Center website. Available at:
http://www.entcolumbia.org/tympperf.html
Accessed August 10, 2015.