What are the other Names for this Condition? (Also known as/Synonyms)

• Eardrum Tear
• Perforated Eardrum
• Tympanic Membrane Perforation

What is Ruptured Eardrum? (Definition/Background Information)

• A Ruptured Eardrum is a hole, perforation, or tear in the eardrum. It is characterized by a sharp pain, fluid or bloody discharge from the ear, and even nausea and vomiting. This condition is more often seen in children than adults
• The eardrum is also known as the tympanic membrane; this membrane lies in between the middle ear and outer ear. Ear infections, injuries, surgical procedures, and exposure to sudden loud noises (explosions) are some potential causative factors for a Ruptured Eardrum
• Additionally, introducing foreign objects into the ear and sudden pressure changes in the middle ear due to increased pressure in the outside environment (caused during air travel or scuba diving), may result in injury to the eardrum
• A healthcare provider may examine the ear using an otoscope, conduct hearing tests, and request tests for determining infections, in order to arrive at an accurate diagnosis of an Eardrum Rupture
• Small tears in the eardrum usually heal by themselves. In some cases, the tear might have to be surgically repaired. Nevertheless, protecting one’s ear from sudden pressure changes and loud noises can help avoid the condition
• The prognosis of Ruptured Eardrum is normally good. In most cases, hearing loss is reported to be temporary. Complications, such as ear infection and cyst formation in the middle ear, may prolong treatment and recovery period

Who gets Ruptured Eardrum? (Age and Sex Distribution)

• Ruptured Eardrum can occur in individuals of all ages and both gender. However, children are reportedly affected more than adults
• There is no racial or ethnic group predilection for this condition

What are the Risk Factors for Ruptured Eardrum? (Predisposing Factors)

The following are certain risk factors associated with a Ruptured Eardrum:

• Use of foreign objects (including earbuds) to clean the ear
• Air travel
• Scuba diving
• A direct blow to the ear
• A head injury
• Exposure to a sudden, loud, and powerful noise

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Ruptured Eardrum? (Etiology)

The following are some known causes for a Ruptured Eardrum:

• Middle ear infection: An ear infection can lead to the accumulation of fluids in the middle ear. The fluid may exert pressure on the eardrum resulting in its rupture/tear
• Barotrauma (‘baro’ indicates pressure): During air travel or scuba diving, the pressure in the middle ear is less than the air/water pressure prevailing outside (which is increased). This causes severe stress on the eardrum that may result in its rupture
• A direct blow/injury to the ear occurring from sports, or from other such physical activities
• Acoustic trauma from loud noises: A loud (strong and powerful) sound, such as from a gunshot, jackhammer, or aircraft, can rupture the eardrum
• Insertion of foreign objects into the ear: Inserting small objects, such as cotton and pins, into the ear, by kids or adults (to clean the ear), can result in an Eardrum Rupture
• Severe head trauma: Head injuries, such as a skull fracture, can damage the ear structure and even affect the eardrum

What are the Signs and Symptoms of Ruptured Eardrum?

The signs and symptoms associated with Ruptured Eardrum may include:

• Sharp ear pain; constant and continuing ear pain that stops abruptly
• Fluid and/or blood discharge from the ear
• Hearing loss
• Tinnitus: Ringing sound in the ear
• Vertigo or head-spinning sensation
• Nausea and vomiting

How is Ruptured Eardrum Diagnosed?

A healthcare provider may employ one or more of the following methods for an accurate diagnosis of Ruptured Eardrum:

• A thorough physical examination and complete medical history
• Inspection of the affected ear using a powerful light instrument, called an otoscope
• Laboratory test on fluid discharge samples from ear, to check for bacterial or viral infection of the middle ear
• Tuning fork evaluation: Tuning forks are metal instruments that produce sounds of a frequency when struck. This test may be used by the physician to check for hearing loss. It can help ascertain if the hearing loss is caused by damage to the vibrating parts of the middle ear, or to the nerves of the inner ear, or both
• Tympanometry: A device is inserted into the ear canal to check the ear’s response to changes in pressure
• Audiology exam: A series of tests conducted to help ascertain the level of hearing at different volumes and pitches
• On rare occasions, a CT scan of the head and neck may be performed

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Ruptured Eardrum?

Ruptured Eardrum can lead to various complications such as:

• Hearing loss: Usually the hearing loss is of a temporary nature, till the hole or tear heals. The extent of hearing loss depends on the size and location of the tear
• Otitis media: Bacterial infection that can potentially result in hearing loss
• Cholesteatoma or middle ear cyst: Abnormal and benign overgrowth of skin due to repeat rupture of eardrum and infections

How is Ruptured Eardrum Treated?

The treatment options for Ruptured Eardrum depend on the extent of tear in the eardrum:

• If the rupture is small, no special treatment may be required, as it can heal itself over time
• If the tear is large, or if it does not heal on its own, the following may be recommended:
  • Eardrum patch: The tear is closed with the help of a special paper patch
  • Surgery: The most common surgical procedure performed is a tympanoplasty. In this procedure, a tiny patch of the patient’s own tissue is grafted to repair the tear

How can Ruptured Eardrum be Prevented?

The following measures may be useful in avoiding an Eardrum Rupture:

• Seek medical attention for middle ear infections
• Protect ears during air travel, particularly during take-off and landing by considering the following:
  • Use pressure equalizing earplugs
  • Trying to yawn or chewing on gums may help
  • Use the Valsalva maneuver to try and blow air gently, while closing the mouth and nose
  • Avoid sleeping when the flight is ascending or descending
• Avoid using any item/object to clean or remove earwax from the ears
• Wear protective gear, such as earmuffs, if exposure to loud noises is anticipated

What is the Prognosis of Ruptured Eardrum? (Outcomes/Resolutions)

• The prognosis for a Ruptured Eardrum is typically good; however, the prognosis depends on the severity of the injury or tear
• Under normal circumstances and mostly, the perforation heals within 2 months; even if there is a loss of hearing, it is usually temporary
• Severe complications, such as permanent hearing loss, are very rare

Additional and Relevant Useful Information for Ruptured Eardrum:

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/health-topics/ent-center/