Perforated Eardrum: Symptoms, Causes and Treatment

Perforated Eardrum

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Perforated Eardrum

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Eardrum Perforation or a Tympanic Membrane Perforation is a hole or tear in the thin membrane that separates the ear canal from your middle ear (eardrum). The eardrum is the part of the ear that receives vibrations from sound, allowing an individual to hear.

Eardrum perforation can lead to loss of hearing. Usually, it heals within two months, and complications related to the disease are rare. Let's read more about eardrum perforation, its representation by pictures, causes, symptoms, diagnosis, treatment, prevention, and more.

Disease Name Eardrum Perforation
Alternative Name Tympanic Membrane Perforation
Symptoms Hearing loss, Pain in the ear, Itching, Fluid leaking from the ear, Ringing in the ear, Spinning sensation, Nausea and vomiting
Causes Middle ear infection (otitis media), Barotrauma, Loud sounds or blasts (acoustic trauma), Foreign objects in your ear, Severe head trauma
Diagnosis Otoscope (auriscope), Audiology exam
Treated by Otolaryngologist
Treatment options Ear Membrane Surgery (Tympanoplasty), Myringoplasty

What is Eardrum Perforation?

Eardrum Perforation or a Tympanic Membrane Perforation is a hole or tear in the thin membrane (eardrum) that separates the ear canal from the middle ear. The eardrum is the part of the ear that receives vibrations from sound, allowing you to hear. Eardrum perforation can lead to loss of hearing and also can make the middle ear vulnerable to infections. 

Eardrum Perforation Symptoms

The main symptom of eardrum perforation is pain. For some people, pain may remain steady throughout the day, or it can increase or decrease in intensity. Other signs and symptoms of an eardrum perforation may include:

  1. Tinnitus (a noise, buzzing, or ringing in your ears)
  2. Drainage from the ear (blood or pus-like)
  3. Vertigo (spinning sensation), resulting in nausea or vomiting
  4. Episodic ear infections
  5. Facial weakness
  6. A whistling sound in the ear while blowing the nose
  7. Ringing in the ear
  8. Decrease in hearing or hearing loss

Eardrum Perforation Causes

Eardrum perforation can develop in any age group or gender. Below mentioned are some of the most common causes of eardrum perforation:

  1. Acute otitis media (infection in the middle ear) 
  2. Barotrauma (injury to your ears due to sudden changes in air pressure)
  3. Sticking objects like a cotton swab or hairpin in the ear can puncture the eardrum
  4. Acoustic trauma (loud sounds or blasts like explosions or gunshots)
  5. Severe head traumas, like a skull fracture

Eardrum Perforation Risk Factors

An eardrum perforation develops when there is a tear in the eardrum. An individual may be at a higher risk of developing eardrum perforation if he/she has:

  1. An ear infection
  2. History of eardrum ruptures or ear surgery, such as ear tubes
  3. Injury to the ear
  4. Inserted objects in the ear
  5. Done scuba diving

Prevention of Eardrum Perforation

There are multiple things that an individual can do to prevent eardrum perforation. Some of the measures to prevent eardrum perforation are listed below:

  1. Get treatment for middle ear infections
  2. Protect the ears during flight
  3. Keep the ears free of foreign objects
  4. Guard against explosive noise
  5. Use earplugs, chew gum, or force a yawn to keep your ear pressure stabilized

How is Eardrum Perforation diagnosed?

An ENT (ear, nose, and throat) specialist can diagnose a perforated eardrum using various methods such as:

  1. Otoscope: Your healthcare provider will use a lighted instrument to view the ear canal.
  2. Laboratory tests: If there’s discharge from the ear, the doctor may take a swab sample and send it for laboratory testing to detect bacterial infection in the middle ear.
  3. Tuning fork evaluation: Tuning forks are two metal instruments that produce vibration and sound when struck together. The test is used to detect possible hearing loss. 
  4. Audiology exam: The doctor uses this test to examine your hearing range and eardrum capacity at different pitches and volumes. 
  5. Tympanometry: The doctor inserts a tympanometer into your ear to measure your eardrum’s response to slight changes in air pressure.

How to prepare for the doctor's consultation?

If an individual has signs or symptoms of a perforated eardrum, then consult the ear, nose and throat (ENT) specialist. Below mentioned are some of the information that a patient can prepare before the appointment with the specialist.

  1. List down symptoms including any that may seem unrelated to hearing loss, fluid discharge or other ear-related symptoms.
  2. List down the relevant events that may be related to the ear problems, such as a history of infections, recent ear injuries or head traumas, or recent air travel.
  3. The patient should also tell the specialist the list of medications and supplements he/she takes.
  4. Ask questions to the specialist. Some of the questions are as follows:
    1. Do I have a ruptured eardrum?
    2. What else could be causing my hearing loss and other symptoms?
    3. If I have a ruptured eardrum, what do I need to do to protect my ear during the healing process?
    4. What type of follow-up appointments will I need?
    5. At what point do we need to consider other treatments?

Eardrum Perforation Treatment

Most ruptured (perforated) eardrums heal without treatment within a few weeks. Your doctor may prescribe antibiotic drops if there's evidence of any infection. If the tear or hole in the eardrum doesn't heal by itself, treatment will likely involve procedures to close the tear or hole.

Eardrum Perforation treatment by home remedies

Home care tips for treating a perforated eardrum include:

  1. Take pain relievers to ease the pain from eardrum perforation.
  2. Place a warm, dry compress on the ear several times a day.
  3. Do not blow the nose more than necessary, as blowing the nose can create pressure on the ear and hamper the healing process. 
  4. Do not use over-the-counter ear drops unless the doctor prescribes them, as the fluid can get deep into the ears. 
  5. Keep the ear dry while bathing or showering.
  6. Refrain from cleaning the ears until they are healed completely. 

Please note that the selection of the treatment procedure is based on the severity of the condition and the doctor’s opinion. 

Eardrum Perforation treatment with surgery

  1. Eardrum patch: It is done if there is a tear or hole in the eardrum that doesn't close on its own. An ENT specialist may seal it with a paper patch (or a patch made of other material). With this procedure, the ENT specialist may apply a chemical to the edges of the tear, which can promote eardrum healing, and then apply a patch over the hole. The procedure may need to be repeated more than once before the hole closes.
  2. Tympanoplasty: If a patch doesn't result in proper healing, the ENT specialist determines that the tear isn't likely to heal with a patch, he or she may recommend surgery known as Tympanoplasty. In this procedure, the surgeon grafts a patch of tissue to close the hole in the eardrum. This is an outpatient procedure, where the patient can usually go home the same day unless medical anaesthesia conditions require a longer hospital stay. 
  3. Myringoplasty: In this procedure, the perforation is fixed by placing a graft to patch up the eardrum. This procedure is also performed on an outpatient basis. 
Surgery Name Surgery Cost
Tympanoplasty ₹35,000 to ₹1,10,000
Myringoplasty ₹35,000 to ₹75,000
Eardrum Perforation Treatment || image

Risks and Complications of Eardrum Perforation

Usually, a perforated eardrum heals on its own. But, if it does not heal on its own, it can worsen the symptoms and also affect your daily life. Untreated eardrum perforation can lead to uncommon problems such as:

  1. Hearing Loss
  2. Middle ear infection (otitis media): Infection and fluid accumulation can occur in the middle ear.
  3. Middle ear cyst (cholesteatoma): a rare condition in which cysts (composed of skin cells and other debris) can develop in the middle ear.
  4. Bleeding from ear
  5. Yellow discharge from the ear

When to see a doctor?

The patient can consult the doctor if he/she experiences:

  1. Ear pain
  2. Hearing loss
  3. Ringing of ear
  4. Spinning sensation
  5. Nausea and vomiting

Diet for Eardrum Perforation

In the fight to keep the body healthy and functional, vitamins and minerals play a vital role. Some of the minerals are also critical elements in improving hearing health. These include:

  1. Potassium: regulates the fluid in the inner ear. Foods rich in potassium include potatoes, spinach, lima beans, tomatoes, raisins, apricots, bananas, melons, oranges, yoghurt and low-fat milk
  2. Folic acid: helps the body to generate new cell growth and helps increase the circulation of blood in the body. Foods rich in folic acid include fortified breakfast cereal, liver, spinach, and broccoli.
  3. Magnesium: acts as a protective barrier to hair cells in the inner ear when loud noises are emitted. Foods rich in magnesium include bananas, potatoes, spinach and broccoli.
  4. Zinc: is known for increasing cell growth and healing wounds. Zinc-rich foods include cashews, almonds, peanuts, beans, and split peas.
  5. Omega 3 Fats & Vitamin D: have anti-inflammatory and anti-ageing properties. Foods rich in Omega 3s include flaxseed oil, krill oil, salmon, and soybean oil.

FAQs for Perforated Eardrum

What is eardrum perforation?

is a hole or tear in the thin membrane that separates the ear canal from your middle ear (eardrum). The eardrum is the part of the ear that receives vibrations from sound, allowing you to hear. Eardrum perforation can lead to loss of hearing.

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What is the common symptoms of eardrum perforation?

The main symptom of eardrum perforation is pain. For some people, pain may remain steady throughout the day, or it can increase or decrease in intensity. Other symptoms include Itching, Fluid leaking from the ear, ringing in the ear, Spinning sensation, Nausea and vomiting.

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What is the common cause of eardrum perforation?

The main cause of eardrum perforation is a middle ear infection, barotrauma, loud sounds or blasts (acoustic trauma), and foreign objects in your ear.

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What is a complication of a eardrum perforation?

The most common possible complication of eardrum perforation include hearing loss, middle ear infection, and in rare cases, middle ear cyst formation.

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Can a ruptured eardrum cause permanent damage?

A tear in the eardrum can allow bacteria and other things to get into the middle ear and inner ear. This could lead to an infection that might cause more permanent hearing damage.

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How is a eardrum perforation diagnosed?

An ENT (ear, nose and throat specialist) may identify the tear or the hole in your eardrum by using methods like an otoscope, or an audiology exam.

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How can I prevent a eardrum perforation?

To prevent an eardrum perforation, you can protect your ears by wearing ear plugs when around loud noises, by not sticking objects into the ear canal that could puncture the eardrum and by consulting the doctor right away if you feel pain or experience the symptoms of ear infection.

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What are the treatment options for eardrum perforation?

Your ENT specialist will recommend you one of the treatment options based on your symptoms. Some of the treatment methods for treating the condition if the symptoms are mild include ear drops and antibiotics as prescribed by your doctor. Surgical methods for treating eardrum perforation include eardrum patches,  tympanoplasty and myringoplasty.

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When does a perforated eardrum need surgery?

If a perforation has been present for more than 3 months without infection or drainage it is unlikely to close by itself. At this point, your doctor may recommend that you consider having the hole closed surgically.

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How long does it take to recover from eardrum surgery?

Most people are able to go back to work or their normal routine in about 1 to 2 weeks. But if your job requires strenuous activity or heavy lifting, you may need to take 2 to 4 weeks off.

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How can I speed up the healing of a ruptured eardrum?

At home, you can ease the pain of a ruptured eardrum with heat and pain relievers. Placing a warm, dry compress on your ear several times daily can help.

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Does insurance cover treatment for eardrum perforation?

Yes, all health insurance plans cover the treatment for eardrum perforation. Paperwork is facilitated by our team on your behalf ensuring smooth approval and a cashless facility. Contact HexaHealth for a simple cashless and hassle-free experience.

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What is the cost of eardrum perforation surgery?

The cost of eardrum perforation surgery is variable, considering the type of hospital chosen, the severity of the condition, the technique recommended, the patient's medical condition based on age and other health factors, etc. Contact HexaHealth for price transparency.

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What are the side effects of eardrum perforation surgery?

Possible side effects of eardrum perforation surgery include allergies to tape, suture materials, glues, blood products, topical preparations or injected agents, anaesthesia risks, bleeding (hematoma), blood clots, change in skin sensation, infection, and pain that may persist for long.

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What are the myths versus facts about eardrum perforation?

  1. Myth: The eardrum is perforated, and you need surgery to close it.
    Fact: Eardrum perforation can occur after a middle ear infection or by trauma due to cotton buds or a variety of other foreign objects that people stick in their ears. All these perforations will close in time. In some cases, it may take weeks, but the eardrum has a natural tendency to close by itself.
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Updated on : 13 April 2023


Dr. Aman Priya Khanna

Dr. Aman Priya Khanna

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Shivani Arora

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