Perforated Eardrum: Functions, Causes, Symptoms, Diagnosis, Treatment, Prevention and Complications

A ruptured or perforated eardrum is a hole or rip in the thin tissue that separates the eardrum (middle ear) from the ear canal (tympanic membrane perforation).

An eardrum rupture may be the source of the hearing loss. Additionally, it can make middle ear infections more likely.

An untreated ruptured eardrum often heals in a matter of weeks. But occasionally, recovery necessitates a surgical fix or patch.

Functions Of Eardrum

The eardrum, also known as the tympanic membrane, serves two primary functions:

• Listening: The first structure in the middle and inner ears to convert sound waves into nerve impulses is the eardrum. As sound waves hit it, it vibrates.
• Defense: The eardrum also acts as a barrier to prevent foreign objects, bacteria, and water from entering the middle ear.

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Causes Of Perforated Eardrum

A rupture or perforation of the eardrum may result from one of the following:

• Middle ear infection (otitis medium): A middle ear infection often results in fluid buildup in the middle ear. The pressure these fluids exert could cause an eardrum rupture.
• Barotrauma: Barotrauma is the result of stress being applied to the eardrum due to an imbalance between the air pressure in the middle ear and the surrounding air pressure. Intense pressure can cause the eardrum to rupture. The most frequent cause of barotrauma is the air pressure changes caused by flying airplanes.
• Additional events that could cause sudden changes in pressure and potentially an eardrum rupture are direct hits to the ear, such as the collision of an airbag in an automobile, and scuba diving.
• Loud sounds or explosions (acoustic trauma): Because such sound is essentially an overwhelming sound wave, it is rare that an explosion or gunshot will cause an eardrum to burst.
• A foreign object in your auditory canal: An eardrum rupture or ripping can occur from little objects such as a cotton swab or hairpin.
• Serious head injuries: Serious injuries, including a fractured base of the skull, can cause damage to the eardrum and other middle and inner ear structures.

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Symptoms Of Perforated Eardrum

The following are some warning indications and symptoms of an eardrum rupture:

• Ear pain that might go quickly
• Hearing loss from mucus-like, pus-filled, or blood-filled ear discharge
• The spinning sensation in the ears, often known as tinnitus or vertigo
• Nausea or vomiting that could result from vertigo

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Diagnosis Of Perforated Eardrum

Using an otoscope or microscope, your healthcare provider or an ENT specialist can typically visually diagnose an eardrum rupture (perforation) in patients.

Your doctor may order more tests or do them himself in order to detect any hearing loss or to determine the cause of your ear problems. These tests consist of:

• Lab experiments: If there is discharge coming from the ear, your doctor may recommend a culture or laboratory test to rule out a bacterial middle ear infection.
• Fork tuning evaluation: Metal objects having two prongs that produce sound when struck are called tuning forks. Your healthcare provider can use simple testing with tuning forks to determine whether you have hearing loss.
• A tuning fork examination can also reveal if hearing loss is caused by damage to the vibrating elements of the middle ear (such as the eardrum), the inner ear's sensors or nerves, or both.
• Tympanometry: An instrument called a tympanometer is inserted into the ear canal to track the eardrum's response to minute changes in air pressure. Certain reaction patterns may point to an eardrum perforation.
• An audiology test: We'll administer a series of tests to evaluate your hearing at different volumes and pitches. We conduct the testing in a soundproof booth.

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Treatment Of Perforated Eardrum

When left untreated, most ruptured (perforated) eardrums heal in a couple of weeks. If your doctor finds signs of disease, they might give you antibiotic drops. If the eardrum rupture or hole doesn't heal on its own, treatment will likely need surgeries to seal the wound. These could include:

• An eardrum patch: If an eardrum rip or hole does not heal on its own, an ENT specialist may apply a paper patch or patch made of another material to seal it. In order to facilitate the healing of the eardrum, your ENT doctor may perform this office procedure by first applying a chemical to the borders of the tear and then filling the hole with a patch. Prior to the hole, the process might need to be repeated more than time.
• Surgery: If a patch is deemed ineffective in promoting sufficient healing or if it is concluded that the tear is unlikely to heal with a patch, your ENT expert may recommend surgery. The most often used surgical method is called tympanoplasty. Your surgeon will use a patch of your own tissue that they graft to seal the eardrum hole. This procedure is done in an outpatient environment. After an outpatient procedure, you can usually go home the same day, unless there are issues with medical anesthesia that require a prolonged hospital stay.

Prevention Of Perforated Eardrum

Follow these precautions to avoid an eardrum rupture (perforation):

• Seek treatment if you have middle ear infections. Identify the signs of a middle ear infection, which include fever, nasal congestion, ear pain, and diminished hearing. Children with middle ear infections may become fussy or even refuse to eat. To prevent potential eardrum damage, schedule an assessment with your doctor right away.
• Keep your ears covered when you're flying. Try not to fly if your ears or nose are congested due to a cold or allergy. During takeoffs and landings, keep your ears clear by chewing gum, yawning, or using pressure-equalizing earplugs.
• Alternatively, you might do the Valsalva procedure, which entails sealing your nose and gently inhaling air into your nose while holding your lips shut.
• Anything unfamiliar should be kept out of your ear. To get rid of excess or hardened earwax, never use a cotton swab, paper clip, or hairpin. These items have the ability to easily rip or rupture the eardrum. Discuss with your children the dangers of getting strange objects in their ears.
• Avoid loud, explosive noises. Avoid engaging in any activity that could endanger your ears. If your employment or hobbies require you to participate in scheduled loud noise-producing activities, use protective earmuffs or earplugs to prevent unnecessary damage to your ears.

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Complications Of Perforated Eardrum

An eardrum rupture might cause uncommon problems, especially if it doesn't heal on its own in three to six months. A few of the possible problems are:

• Loss of hearing: Usually, hearing loss is temporary, lasting only until the hole or rip in the eardrum heals. The size and location of the rupture may have an impact on the degree of hearing loss.
• Infection in the middle ear (otitis media): Bacteria may be able to enter the ear due to an eardrum rupture (perforation). A small percentage of persons may be susceptible to persistent (recurrent or chronic) infections if their perforated eardrum doesn't heal. Chronic leakage and hearing loss are possible in this small group.
• Cholesteatoma, or middle ear cyst: This skin-cell- and debris-filled cyst is extremely unusual, yet it can form in the middle ear as a long-term consequence of an eardrum rupture.
• Earwax, which shields the ears, usually helps ear canal material get to the outer ear. Skin fragments may enter the middle ear and develop into a cyst if the eardrum ruptures.

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