EARDRUM, RUPTURED

General Information

DEFINITION--A perforation of the thin membrane (tympanic membrane) that separates the inner ear from the outer ear.

BODY PARTS INVOLVED--Eardrum (tympanic membrane); middle ear.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Sudden pain in the ear.
• Partial hearing loss.
• Bleeding or discharge from the ear. The discharge may resemble pus within 24 to 48 hours after rupture.
• Ringing in the ear.
• Dizziness.

CAUSES

> Perforation of the eardrum when a sharp object is inserted in the ear, such as: a cotton swab to clean the ear or relieve an itch; an unseen twig on a tree; hot slag from an industrial site.

> Sudden inward pressure in the ear, such as with: a slap; a swimming or diving accident; a nearby explosion.

• Sudden outward pressure or suction, such as with a kiss over the ear.
• Severe middle-ear infection.

RISK INCREASES WITH

• Recent middle-ear infection.
• Head injury.

HOW TO PREVENT

• Don't put any object into the ear canal.
• Avoid injuries that may cause a rupture (see Causes).
• Obtain prompt medical treatment for middle-ear infections.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor. When the eardrum ruptures, contents of the middle ear (primarily bones) can be seen with a special instrument called an otoscope. A healthy eardrum is almost transparent.
• Culture of the fluid from the ear (sometimes).

APPROPRIATE HEALTH CARE

• Self-care. Treatment involves medication to prevent infection and supportive care for pain.
• Doctor's treatment.
• Microsurgery to repair the perforation (rare).

POSSIBLE COMPLICATIONS

• Ear infection.
• Some permanent hearing loss (rare).

PROBABLE OUTCOME--

• The eardrum will usually repair itself in a week or two (but may take up to 2 months) and normal hearing is restored. If it becomes infected, the infection is curable with treatment.
• If the perforation does not heal, minor surgery is needed.

How To Treat

GENERAL MEASURES--

• Don't blow your nose, if possible. If you must, blow gently.
• Don't use cotton swabs except to clean the out ear.
• Keep the ear canal dry. Don't swim, take showers or get caught in the rain. Insert a wisp of cotton in the ear canal to keep moisture out of it when bathing.

MEDICATION--Your doctor may prescribe:

• Antibiotics to prevent or treat infections.
• Pain relievers. For minor pain, you may use non-prescription drugs such as acetaminophen.

ACTIVITY--Resume your normal activities as soon as symptoms improve.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of a ruptured eardrum, especially a pus-like discharge.
• The following occurs during treatment: Fever. Pain that persists, despite treatment. Dizziness that continues longer than 12 to 24 hours.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.