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Perforated Eardrum

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

What Is Tympanic membrane or ear and its perforation?

It 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 a period of 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 Are the Causes of Perforated Eardrum?

A perforated eardrum can be caused by the following reasons:

-Ear Infections: Ear infections can cause ruptured eardrum and is 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).


The ENT specialist will diagnose the perforated eardrum by taking a detailed case history and following 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 with light fitted to it 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: Tuning fork is a metal instrument that is struck against a surface and will vibrate. 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 pertorated eardrum.
  • Hearing Test: This test is done to analyze how well one can hear at different volumes and pitches. These tests are carried out in a soundproof booth.

How is it 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 is prevailing 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.

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 can damage the bones in the middle ear.
  • Hearing Loss – Even though it is a temporary condition caused due to the perforated eardrum, the intensity and the 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 so as 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 so as 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.


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 from 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. But it is always advised to consult a doctor in case you suspect any perforated eardrum.

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