The eardrum, also known as the tympanic membrane, is a key part of our ability to hear. This thin, flexible tissue, located in the middle ear, vibrates with sound waves to transmit them to the brain. However, when it’s perforated, this process breaks down, causing discomfort ranging from pain to hearing loss or infections. This problem, known as a perforated or ruptured eardrum, affects people of all ages and can result from a range of factors, from infections to direct injury.
Although it may seem like a serious problem, many perforations heal with the right care.
Let’s talk about how to recognise it, its possible causes, and what to do to treat and prevent it.
Symptoms of a perforated eardrum
A perforated eardrum usually causes characteristic symptoms, although their severity can vary. The most common signs include:
- Ear pain: It can be intense and constant, or come and go.
- Hearing loss: The person may notice reduced hearing in the affected ear.
- Ringing (tinnitus): A constant or intermittent sound heard in the ear.
- Discharge: Clear, bloody or pus-like fluid may drain from the ear, especially if there’s an infection.
- Dizziness or vertigo: Some people may feel dizzy or have balance problems. Vertigo can, in turn, also cause nausea.
These symptoms can vary depending on the cause of the perforation and whether there’s an infection or other complications.
Causes of a perforated eardrum
Knowing the causes can help you prevent this problem. The most common are:
- Ear infections: Infections, especially in children, can cause pressure to build up in the middle ear, eventually tearing the eardrum.
- Injuries or trauma: A direct blow to the ear, a fall, or even exposure to a loud sound like an explosion, can rupture the tympanic membrane. In more severe injuries involving the base of the skull, the structures of the middle and inner ear can be damaged, including the eardrum.
- Pressure changes (barotrauma): Activities like diving, skydiving or flying can cause sudden pressure changes in the ear, which in turn can cause a perforation.
- Foreign objects: Inserting objects such as cotton buds or paperclips into the ear increases the risk of eardrum damage.
- Exposure to loud sounds: Explosions or sudden exposure to intense sound can generate shockwaves that damage the eardrum.
Diagnosis: how do you know if you have a perforated eardrum?
A perforated eardrum should be diagnosed by a healthcare professional, usually an ENT doctor. A typical examination includes:
- Symptom assessment: The doctor usually starts by reviewing the reported symptoms and the patient’s medical history.
- Otoscope examination: Using an otoscope, the ear canal and eardrum are examined. If it’s ruptured, a hole in the tympanic membrane may be visible.
- Hearing tests: To measure the degree of hearing loss, audiometric tests may be carried out to determine the patient’s current hearing ability.
A quick, accurate diagnosis is key to avoiding bigger complications.
Treatment: what to do about a perforated eardrum
Treatment for a perforated eardrum depends on the severity of the perforation and whether there’s an infection. Options include:
- Home care: In many cases, the eardrum can heal naturally within a few weeks. During this time, it’s important to keep the ear dry and avoid inserting objects. Over-the-counter painkillers can help manage pain.
- Antibiotics: If the perforation is due to an infection, or if there’s a risk of one developing, the doctor may prescribe antibiotic drops to prevent further complications.
- Myringoplasty: In cases where the eardrum doesn’t heal on its own, a procedure called myringoplasty is used, which involves placing a small patch over the tympanic membrane to support its recovery.
- Tympanoplasty: This surgery is used in more complex situations, where the doctor takes tissue from another part of the body to close the hole in the eardrum. It’s a more invasive procedure, but effective in severe or chronic cases.
Our professional opinion: We’ve seen patients try to treat themselves at home with home remedies, but this is a mistake. Putting liquids in the ear or handling it yourself only makes things worse. We always recommend seeing a doctor.
Complications to avoid
A perforated eardrum might seem like a minor issue, but if it’s not treated properly, it can lead to serious problems:
- Recurring infections: With a perforation, the eardrum leaves the middle ear vulnerable to bacteria, increasing the risk of infection.
- Hearing loss: Some people may experience prolonged or permanent hearing loss, depending on the severity of the perforation.
- Cholesteatoma: In chronic cases, skin deposits called cholesteatomas can form in the middle ear, which can damage the tiny bones of the ear and cause hearing loss.
Preventing these problems depends on following medical advice to the letter.
Recovery: tips for looking after your ear
Recovering from a perforated eardrum can take several weeks or even months, depending on the extent of the damage, and requires patience and care:
- Keep the ear dry: Avoid getting water in the ear while bathing or swimming. Earplugs can be used if needed.
- Don’t insert objects: Even if it itches or feels uncomfortable, it’s important not to put anything into the ear, as this can make the injury worse.
- Avoid blowing your nose hard: This can increase pressure in the middle ear and delay recovery.
- Follow the prescribed treatment: If antibiotic drops have been prescribed, it’s important to use them as directed to prevent infection.
In our experience, custom-made moulds to keep water out are an excellent solution. They help patients feel more confident while showering or swimming.
Prevention: how to avoid it happening
Preventing a perforated eardrum is possible with simple habits:
- Avoid inserting objects into the ear: This includes cotton buds and other small objects that can cause injury.
- Take care while diving and flying: When diving or flying, it helps to chew gum, swallow, or perform Valsalva manoeuvres to equalise the pressure in the ear.
- Use hearing protection: Prolonged or repeated exposure to loud noise can damage the eardrum; using earplugs or protective earmuffs helps prevent damage.
Looking after your ears means looking after your quality of life
A perforated eardrum is a problem that can be painful and affect hearing temporarily or even permanently, but it can be avoided with simple precautions. If it happens, acting quickly and following medical advice is key to a smooth recovery. Although many perforations heal on their own, protecting your ear from water and avoiding unsuitable home remedies will make all the difference.
As hearing care specialists, we recommend that our patients with a perforated eardrum avoid using solutions or hydrogen peroxide to clean earwax from their ears, and also avoid ear irrigation with a syringe, a method that’s still quite common at some health centres. Our recommendation is to see an ENT doctor, who will use a different technique to clean the ear or remove any blockage, without needing to rely on that method.
No liquid or water should go into the ear, so when showering or bathing, the ear should always be protected. That’s why we make our patients swimming moulds that seal the ear canal perfectly, keeping water out to avoid discomfort and possible complications.
If you have ear discomfort, or simply need custom-made moulds to protect yourself while bathing or showering, at our hearing centre in Valencia we have experts who will give you the personalised attention you need to look after your hearing health.
Remember that prevention and early treatment are key to avoiding complications.
Visit us and find out how we can help keep your ears healthy and protected!
