Perforated Eardrum - Ruptured Eardrum

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Introduction

A perforated or ruptured eardrum is an eardrum with a hole in it.  The condition may result from air pressure changes, loud noise, infection, or injury.  A perforated eardrum causes sudden intense pain and hearing loss.  The condition may heal on its own or may be repaired with other treatments, including surgery.
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Anatomy

The ear is divided into three areas: the outer, middle, and inner ear.  Your ear not only enables you to hear, but it plays a role in balance as well.  Your outer and middle ear are separated by your eardrum.
 
The medical term for eardrum is tympanic membrane.  It prevents anything from entering your inner ear.  Sound causes your eardrum to vibrate.  The vibrations are translated into nerve messages that are sent to your brain.  Your brain processes the nerve messages so that you hear.
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Causes

A hole in the eardrum can result from an infection, pressure, loud noise, or injury.  Foreign objects, such as putting a cotton swab too far in the ear, can injure your eardrum.  The eardrum may also rupture if your ear is slapped or hit.
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Symptoms

Eardrum perforation causes a sudden intense pain.  You may experience a decrease in hearing or hearing loss.  Your ear may bleed.  Without the protective membrane, your ear is vulnerable to germs.  An ear infection may develop causing pus and drainage.  You may have a fever and hear unusual noises, such as buzzing or ringing in your ear.  In some cases, vertigo may result.  Vertigo is the false sense that the room is moving or spinning.  It can cause balance problems.
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Diagnosis

You should contact your doctor if you suspect you have perforated your eardrum.  Your doctor will review your medical history and examine your ear.  The inside of your ear will be examined with an otoscope.  An otoscope is a lighted device with a magnifying glass.  If pus is present, a sample may be tested to determine what type of infection it is.  You may be referred to an otolaryngologist, a doctor that specializes in ear, nose, and throat conditions.  A hearing test may be done to measure your degree of hearing loss.
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Treatment

In many cases, a perforated eardrum heals itself.  Your doctor may prescribe pain medication and antibiotic eardrops.  A dressing may be placed over your ear to prevent further injury and infection.  A series of patches may be placed on your eardrum to help it heal. 

Surgery is used when other treatments fail.  A tympanoplasty is an outpatient surgery that is used to treat eardrum perforation.  It involves attaching tissue that is taken from another place on your body to your eardrum to help it heal.  This may restore hearing.
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Prevention

You may help prevent a perforated eardrum by having ear infections treated immediately.  It may be helpful to avoid flying when you have a cold, ear infection, or sinus infection.  Do not place objects deep within your ear.  Use cotton swabs with care.  Wear regulation earplugs if you are shooting a gun at a firing range, working in a loud environment, or around other loud noises. 
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Am I at Risk

Risk factors for eardrum perforation:

_____ Flying in an airplane, especially if you have a cold or allergies
_____ Diving underwater
_____ Loud noises, such as gunfire or explosions
_____ Foreign objects can penetrate the eardrum
_____ A hit or slap to the ear
_____ Ear infections

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Complications

Perforated eardrum can lead to infection and hearing loss.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.