What is tympanitis?
Tympanitis is the medical term for an inflamed tympanic membrane, also known as the eardrum. This membrane can become inflamed for a number of reasons, from bacteria to trauma. When the membrane is inflamed, it can have a serious impact on your hearing.
Function of the eardrum
The eardrum is a thin, fragile, and pliable membrane that stretches across the ear canal, much like skin stretches across a drum. This sheet-like barrier separates the ear canal from the middle ear, and plays an important role in hearing.
When sound waves strike the eardrum, tiny bones in the middle ear vibrate, transmitting nerve impulses to the inner ear and then the brain, where the sounds are eventually interpreted. When the eardrum is inflamed, however, sounds don’t vibrate properly. The swelling winds up causing pain and hearing becomes distorted.
If the eardrum remains inflamed or continually swells, not only can hearing be affected, but so can speech, especially in young children who need to hear clearly in order to mimic speech correctly.
Use this interactive 3-D diagram to explore the eardrum.
Common causes of tympanitis
The inflammation that causes tympanitis can result from a number of factors, including:
Middle ear infections
The most common type of ear infection is acute otitis media (AOM), an ear infection of the middle ear. While adults are not immune, AOM is generally a disorder of children, who have shorter Eustachian tubes than adults.
The Eustachian tubes help drain fluid from the middle ear. When the Eustachian tubes become blocked— usually because of congestion from a cold or allergies — fluid builds up, eventually pressing against and irritating the delicate eardrum. Trapped in the moist, dark environment of the middle ear, this fluid is also likely to start breeding bacteria, causing an ear infection. According to research, up to 85 percent of children will have AOM in the first year of life.
The eardrum is a very thin and sensitive layer of tissue, easily injured when poked or knocked.
Put a cotton swab, finger, ear bud or any foreign object too far down the ear canal and you can easily scratch the eardrum, causing inflammation and pain. Dig too far and you may even burst the eardrum (called a perforated eardrum). The eardrum can also become injured from a blow to the head.
This is an infection of the eardrum, usually caused by the same bacteria that cause middle ear infections. In fact, they often occur simultaneously. Bullous myringitis is characterized by fluid-filled blisters on the eardrum.
While swimmer’s ear (also called otitis externa) is technically an infection of the ear canal, it can irritate the eardrum, causing tympanitis. This condition is caused by bacteria or fungi and is common in swimmers because excessive moisture can break down the skin, allowing germs access.
Symptoms of tympanitis
A bulging eardrum generally occurs in conjunction with other ear disorders or problems, the symptoms of which can all be intertwined. Some of them include:
- pain in one or both ears
- a feeling of fullness in the ear, due to fluid trapped behind a bulging eardrum
- a bloody, watery discharge from the affected ear (if the eardrum swells to such a degree that it bursts)
- hearing loss, usually temporary
- possible fever
- irritability, sleeplessness, and ear pulling in young children
How tympanitis is diagnosed
To visualize the ear canal and the eardrum for signs of inflammation and infection (bulging, thickened, red tissue, and/or blisters), your doctor will use an otoscope. This is an instrument with a light and a magnifying lens that is inserted into the ear canal.
Your doctor may also outfit the otoscope with a bulb that allows them to force air into the ear canal, to see how the eardrum moves. When pus and fluid collect in the middle ear causing the eardrum to bulge, the eardrum will not move properly.
How tympanitis is treated depends on its cause.
Middle ear infection
If a middle ear infection is causing eardrum problems, your doctor will probably advise using pain relievers like acetaminophen and ibuprofen.
Your doctor may hold off on prescribing an antibiotic, despite the fact that many ear infections are caused by bacteria. That’s because many kids with ear infections get better on their own — with or without treatment — within a few days. In fact, research published in Informed Health Online found that 78 kids out of 100 who did not take antibiotics were earache-free 2 to 3 days after diagnosis of an ear infection.
In children with repeated ear infections, ear tubes (tiny cylinder-shaped tubes surgically placed through the eardrum to allow air into the middle ear) may be used.
This infection of the eardrum is generally treated with antibiotics. In some cases, the blisters may be lanced to relieve pain. Oral pain relievers are typically prescribed.
Antibiotic eardrops that also contain steroids to reduce inflammation and possibly antifungals are the standard course of treatment.
Most trauma caused to an eardrum will heal on its own. Even most perforated eardrums will heal without intervention. Pain relievers can make you feel better in the meantime.
Are there cases where someone with tympanitis may need surgery?
Tympanitis usually resolves on its own or with antibiotic treatment, depending on the underlying cause. However, if someone needs surgery, it’s likely due to a complication from a recurrent or chronic ear infection. Recurrent or chronic ear infections can lead to a cholesteatoma (sometimes called a keratoma), which is an abnormal growth of squamous epithelium in the middle ear and mastoid. This condition requires surgery to remove the growth, and in some cases, to restore hearing. Also, as mentioned in this article, some people require the placement of Eustachian tubes for recurrent infections.Alana Biggers, MD, MPHAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Prevention and self-care tips
- Practice thorough hand washing and keep your hands away from your eyes, mouth, and nose to prevent the spread of germs that cause the common cold and associated ear infections.
- Use warm (not hot) compresses on a painful ear. Alternate a few minutes on, a few off.
- Never use cotton swabs, hairpins, or similar objects to clean out ears. Use a damp washcloth instead.
- Make a solution of equal parts alcohol and vinegar and, using an ear dropper, apply a few drops into an ear where water has collected. Do this after swimming, bathing, excessive sweating, and other activities that could cause water to get into the ear. Let the solution sit in your ear for about 30 seconds before tilting your head to let it drain out.
Inflammation of the eardrum is a common occurrence, especially in young children who are prone to ear infections and putting things in their ears. While the eardrum is fragile and susceptible to damage (which can affect hearing), it does tend to heal itself. When it does, pain is generally resolved and hearing loss is restored.
Talk to your doctor if you or your child has persistent ear pain or other symptoms associated with tympanitis. They can diagnose the underlying cause and determine the best course of action.