Eardrums are essential, playing two significant roles in hearing. First and foremost they vibrate when sound waves strike them. Second they provide a barrier that protects the inner ear from infection. When fully intact, the eardrum isolates the inner ear resulting in a sterile and clean environment. If the ear drum is perforated, the inner ear is left susceptible to bacterial infection.
A perforated or ruptured eardrum (in medical language, a tympanic membrane perforation) is what happens when this important membrane is damaged by punctures or tears. There are various causes of punctured ear drums. The most common is an inner ear infection. Fluid at the site of the infection presses up against the eardrum membrane, increasing pressure until it ultimately rips. Some people rupture their own eardrums by poking foreign objects into the ears, for example the use of Q-tips to clear away ear wax. Another well-known root cause is barotrauma – the problem that occurs when the barometric pressure inside the ear is very different from the pressure outside the ear – which can happen in scuba diving and in airplanes. Eardrums can also become perforated due to head injuries or acoustic trauma such as quick loud noises or explosions.
Indications of perforated eardrums include pain in the ear (including persistent pain that stops suddenly), hearing difficulties in the affected ear, vertigo or dizziness, and fluid draining from the ear. A perforated ear drum should be evaluated and treated by a doctor. Timely attention is vital to prevent hearing damage and infection. What you risk by not having these symptoms addressed are serious inner ear infections and cysts, and the possibility of permanent hearing loss.
At your visit the health care provider will look at the eardrum with an instrument called an otoscope. With its internal light, the otoscope gives the doctor a clear look at the eardrum. Ruptured eardrums generally heal on their own in 2 to 3 months, as long as infection is prevented and as long as the individual refrains from activities that could worsen the situation, such as diving or swimming, avoiding medications outside of those prescribed for the condition, and attempting to not blow their nose while the healing is taking place. If the rip is sizeable or occurs near one of its edges, the doctor may insert a temporary dam or patch to reduce the risk of infection; in very rare situations, surgical treatment may be necessary.
Any pain can be addressed by using over-the-counter (OTC) pain medications such as aspirin or acetaminophen. Not every ruptured eardrum can be averted, but there are steps you can take to reduce your chances. Always get timely treatment for any ear infections and never put any foreign objects into your ear (even for cleaning).