Your eardrum, also called the tympanic membrane, is a thin layer of tissue that separates the outer part of your ear from your middle ear. It sends sound vibrations from the world around you to tiny bones in your middle ear. This helps you to hear.

Sometimes, your eardrum gets pushed inward toward your middle ear. This condition is known as a retracted eardrum. You might also see it referred to as tympanic membrane atelectasis.

A retracted eardrum usually doesn’t cause any symptoms. However, if it retracts enough to press on the bones or other structures within your ear, it can cause:

  • earache
  • fluid draining from the ear
  • temporary hearing loss

In more severe cases, it can cause permanent hearing loss.

Retracted eardrums are caused by a problem with your Eustachian tubes. These tubes drain fluid to help maintain even pressure inside and outside of your ears.

When your Eustachian tubes aren’t working correctly, decreased pressure inside your ear can cause your eardrum to collapse inward.

Common causes of Eustachian tube dysfunction include:

To diagnose a retracted eardrum, your doctor will start by asking about your symptoms and whether you’ve recently had an ear infection. Next, they’ll use a device called an otoscope to look at the inside of your ear. This will allow them to see if your eardrum is pushed inward.

To treat a retracted eardrum, you’ll see a specialist called an ear, nose, and throat specialist. However, not all retracted eardrums require treatment. Mild cases often improve as pressure in your ear returns to its usual level. This can take up to several months, so your doctor may just recommend keeping an eye on your symptoms before starting any treatment.

More severe cases require treatment to increase airflow in your ear. Adding more air to your middle ear can help to normalize pressure and fix the retraction. This is sometimes done using nasal steroids or decongestants.

Your doctor might also suggest performing the Valsalva maneuver to help normalize the pressure in your ears. You can do this by:

  • closing your mouth and pinching your nose closed
  • breathing out hard while bearing down, as if you were having a bowel movement

Do this for 10 to 15 seconds at a time. It’s best to do this under the direction of your doctor to avoid creating more problems for your ears.

If a retracted eardrum starts to press on the bones of your ear and impact hearing, you may need surgery. This usually involves one of the following procedures:

  • Tube insertion. If you have a child who gets frequent ear infections, their doctor might recommend inserting ear tubes into their eardrums. The tubes are placed during a procedure called myringotomy. This involves making a small cut in the eardrum and inserting the tube. The tube allows air to get into the middle ear, which helps to stabilize pressure.
  • Tympanoplasty. This type of surgery is used to fix a damaged eardrum. Your doctor will remove the damaged part of your eardrum and replace it with a small piece of cartilage from your outer ear. The new cartilage stiffens your eardrum to prevent it from collapsing again.

Minor ear retractions often don’t cause symptoms and resolve on their own within a few months. However, more serious retractions lead to ear pain and hearing loss. In these cases, your doctor may prescribe a decongestant or recommend surgery.