What is a ruptured eardrum?

The eardrum is a thin, transparent layer of cells inside the ear canal. It separates the outer ear from the delicate structures of the middle and inner ear. Besides protecting the inner and middle ear from cold, wind, earwax, and anything else that might find its way into your ear, the eardrum helps you hear. It is called the eardrum not just because it looks like a drumhead, but also because it functions like one. The eardrum receives vibrating sound waves and transmits them to the tiny bones in your ear.

Your eardrum is ruptured if there is a tear or hole in it. This opening exposes the middle ear and inner ear organs to potential damage or injury. It also usually causes at least a temporary decrease in hearing.

How does it occur?

The most common cause of a ruptured eardrum is a middle ear infection (otitis media). When the infection causes a buildup of pus or fluid in the middle ear, pressure increases in your ear and is painful. This buildup of fluid can cause the eardrum to burst.

Injury is also a common cause of a ruptured eardrum. A tear can happen if you try to clean your ear with a cotton-tipped swab or other object. An injury to the side of the head or a straight-on blow to the ear can also cause the eardrum to rupture. The pressure caused by such injuries is more than the thin eardrum can withstand.

What are the symptoms?

Often there are no symptoms. When the rupture is caused by a middle ear infection, you may feel a sudden sharp pain. However, in the case of an ear infection, you may actually feel a sudden decrease in pain as the built-up fluid drains out.

When the rupture is caused by an injury, your only symptom may be general discomfort from the injury itself. You may have some bleeding from your ear.

Over a period of a few days after the rupture you may:

• have some discomfort in your ear (especially in cold or windy weather)

• have a sense that something is just not right in your ear

• have decreased hearing.

How is it diagnosed?

Usually your health care provider can see the tear by looking into your ear canal using an otoscope (a light tool for looking in ears). Sometimes a rubber bulb attached to the otoscope is used to blow a puff of air into the ear to try to make the eardrum move. A normal eardrum moves when the air reaches it; an eardrum with a hole in it does not move.

How is it treated?

A small hole in the eardrum often heals itself, sometimes within a couple weeks. During this time your ear needs to be protected from water (for example, in the bath, shower, or pool). Your ear will feel better if you protect it also from cold air.

Do not use any ear medicines except those prescribed by your doctor for this specific ear problem.

Large holes or unhealed small holes are repaired by surgery. The surgical repair is usually a simple procedure and does not require staying overnight in the hospital.

Sometimes artificial eardrums are created for children or adults who have frequent ear infections and infected drainage.

How long do the effects last?

A tiny rupture in your eardrum usually heals within 3 weeks.

How can I help prevent a ruptured eardrum?

If you have symptoms of an ear infection, such as an earache or feeling of blockage in the ear, see your health care provider promptly.