Perforated Eardrum: a patient’s guide

Introduction

The eardrum (also known as the tympanic membrane) is a thin, skin-like structure that separates the outer ear from the middle ear.

A perforated eardrum occurs when there is a tear or hole in the eardrum. Although uncomfortable, it often heals by itself within 6-8 weeks.

What causes a perforated eardrum?

Middle Ear Infections

This is the most common cause. During middle ear infections, pus build up behind the eardrum, which can cause it to rupture when the pressure gets too much. This is often associated with discharge from the ear

Injury

This includes a punch to the ear and poking an object (such as a cotton bud) into the ear.

Loud Noises

Sudden loud noises (for example, an explosion) can tear the eardrum. This is often associated with severe hearing loss and ringing in the ears (tinnitus).

Changes in Air Pressure (Barotrauma)

Sudden changes in air pressure, such as changing altitude in an aircraft during descent, causes a big difference between the pressure outside the ear and in the middle ear. Pain in the ear is due to a tensed eardrum. Rarely, this can result in a perforated eardrum.

What are the symptoms of a perforated eardrum?

• Hearing loss. The extent depends on the size of the hole – the bigger the hole, the larger the hearing loss. Hearing loss is temporary and returns once the eardrum heals.
• Ear discomfort
• Discharged from the ear. This includes pus, mucus and occasionally blood.
• Ringing in the ear (tinnitus)

How is perforated eardrum diagnosed?

The doctor will use a special torch called an otoscope to examine your eardrum. Sometimes, it may be difficult to visualise your eardrum especially if there is a lot of wax or discharge in the ear.

How is it treated?

• In most cases, the eardrum will heal by itself without any treatment within 6-8 weeks.
• Painkillers such as paracetamol and ibuprofen are sometimes used to relieve ear discomfort.
• Your doctor may prescribe antibiotics if there is an infection or if there is a high risk of an infection whilst the eardrum heals. This can be in the form of tablets or ear drops.
• Rarely, surgery is required to patch the hole in the eardrum should the hole persists with significant hearing loss.

Is there any advice?

The eardrum normally forms a natural barrier to protect the middle ear. A hole in the eardrum exposes the middle ear and thus increases the risk of developing a middle ear infection. Hence, it is important to keep your ear dry.

• AVOID swimming or diving until your eardrum heals
• TAKE CARE not to get water into the ear when you shower
• BE AWARE of symptoms of middle ear infection – fever. In children, this may manifest as irritability, feeling hot, poor feeding, vomiting and pulling or tugging their ear. See you GP should any of these symptoms develop.

Where can I find out more information about perforated eardrum?

• Patient website
• NHS Inform website
• If you require more information, you can contact your GP or NHS Inform (0800 22 44 88) during out of hours.

If you need this information in another language or format, please e-mail:

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