Otorhinolaryngologists Health Channel

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

• Drainage from the ear (drainage may be clear, pus, or bloody)
• Ear noise/buzzing
• Earache or ear discomfort
  • May be severe and increasing
  • There may be a sudden decrease in ear pain followed by ear drainage
• Facial weakness or dizziness (in more severe cases)
• Hearing loss in the affected ear (hearing loss may not be complete)

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.