(Tympanic Membrane Perforation; Perforated Eardrum)
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.
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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 over ear or and explosion
- Pressure building up inside the middle ear, as may occur with scuba diving
- Accidental perforation during ear irrigation or foreign body removal
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
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.
You will be asked 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.
While many ruptured eardrums will heal on their own, many may also require treatment to heal properly. Options may include:
Medications may include:
- Oral antibiotics or antibiotic eardrops if an infection is present or possible
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation
If the eardrum does not heal itself, surgery may be required to repair the perforation, usually with a patch.
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
American Academy of Otolaryngology—Head and Neck Surgery
Family Doctor—American Academy of Family Physicians
Canadian Academy of Audiology
Perforated eardrum. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/perforated-eardrum. Accessed August 22, 2017.
Traumatic Perforation of the Tympanic Membrane. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/middle-ear-and-tympanic-membrane-disorders/traumatic-perforation-of-the-tympanic-membrane. Updated December 2015. Accessed August 22, 2017.
Tympanic membrane perforation. Baylor College of Medicine website. Available at: https://www.bcm.edu/healthcare/care-centers/center-hearing-balance/conditions/tympanic-membrane-perforation. Accessed August 22, 2017.
Tympanic membrane perforation. University of California, Irvine School of Medicine website. Available at: http://www.ent.uci.edu/learning-center/blog/tympanic-membrane-perforations.asp. Accessed August 22, 2017.
Last reviewed September 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 9/30/2013