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Ear anatomy
Ear anatomy


Medical findings based on ear anatomy
Medical findings based on ear anatomy


Mastoiditis - side view of head
Mastoiditis - side view of head


Eardrum repair  - series
Eardrum repair - series


Definition:

A ruptured or perforated eardrum is an opening in the tympanic membrane (eardrum).



Alternative Names:

Tympanic membrane perforation; Eardrum - ruptured or perforated; Perforated eardrum



Causes, incidence, and risk factors:

The tympanic membrane (eardrum) separates the outer ear from the middle ear. The membrane vibrates when sound waves strike it, and this starts the process that converts the sound wave into a nerve impulse that travels to the brain. When the eardrum is damaged, the hearing process is interrupted.

The eardrum also acts as a barrier to keep outside material (such as bacteria) from entering the middle ear. When the eardrum is perforated, bacteria can easily travel to the middle ear -- causing an infection.

Damage to the eardrum can occur from acoustic trauma such as direct injury or barotrauma (pressure-induced damage). Inserting cotton-tipped swabs or small objects into the ear to clean them sometimes causes a perforation of the eardrum. Foreign objects in the ear are another cause of perforated eardrum.

Ear infections may cause a ruptured eardrum as the pressure of fluid in the middle ear increases. Conversely, a ruptured eardrum can cause ear infections because the eardrum is no longer intact, and bacteria can enter the middle ear.



Symptoms:

Signs and tests:

The doctor will look in your ear with an instrument called an otoscope. If the eardrum is perforated, the doctor will see an opening in it, and may even see the bones of the middle ear.

Sometimes it is hard for the doctor to see the eardrum because of drainage (pus)from the ear.

Audiology testing can measure the extent of hearing loss.



Treatment:

A ruptured or perforated eardrum usually heals by itself within 2 months. The goal of treatment is to relieve pain and prevent infection.

Antibiotics (oral or eardrops) may be used to prevent infection or to treat an existing infection. Analgesics (pain killers), including over-the-counter medications, may be used to relieve pain.

Occasionally, the health care provider may place a patch over the eardrum while it heals. Surgical repair of the eardrum may be needed, if the eardrum does not heal on its own (tympanoplasty ).

Warmth to the ear may help relieve discomfort. Keep the ear clean and dry while healing. Cotton balls should be placed in the ear while showering or shampooing to prevent water entering the ear.



Support Groups:



Expectations (prognosis):

A ruptured or perforated eardrum may be uncomfortable, but it usually heals by itself within 2 months. Any hearing loss is usually temporary.



Complications:
  • Ear infection (otitis media)
  • Permanent hearing loss
  • Spread of infection to the bone behind the ear (mastoiditis)


Calling your health care provider:

Call your health care provider if you:

  • Have symptoms of a ruptured or perforated eardrum
  • Are diagnosed with a ruptured eardrum, and symptoms last longer than 2 months despite medical treatment
  • Are diagnosed with a ruptured eardrum and develop a persistent fever, general ill feeling, or hearing loss


Prevention:

Do not insert objects into the ear canal, even to clean it. Foreign objects should only be removed by a health care provider. Have ear infections treated promptly.



References:

Bauer CA, Jenkins HA. Otologic Symptoms and Syndromes. In: Cummings CW, Flint PW, Haughey BH, Robbins KT, Thomas JR, eds. Otolaryngology: Head & Neck Surgery. 4th ed. Philadelphia, PA: Mosby Elsevier; 2005: chap 126.

Ramakrishnan K, Sparks RA, Berryhill WE. Diagnosis and treatment of otitis media. Am Fam Physician. 2007; 76(11):1650-8.




Review Date: 4/13/2009
Reviewed By: Alan Lipkin, MD, Otolaryngologist, Private Practice, Denver, Colorado. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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