Perforated Eardrum

Perforated Eardrum
The eardrum and hearing
The eardrum (also called the tympanic membrane) is a thin skin-like structure in the ear. It lies
between the outer and middle ear.
The ear is divided into three parts - the outer, middle and inner ear. Sound waves come into the
outer (external) ear and hit the eardrum, causing the eardrum to vibrate.
Behind the eardrum are three tiny bones (ossicles). The vibrations pass from the eardrum to these
middle ear bones. The bones then transmit the vibrations to the cochlea in the inner ear. The
cochlea converts the vibrations to sound signals which are sent down a nerve to the brain, which we
'hear'.
INTRODUCTION
A ruptured eardrum, like a clap of thunder, can happen suddenly. You may feel a sharp pain in your
ear, or an earache that you've had for a while suddenly goes away. It's also possible that you may
not have any sign that your eardrum has ruptured.
A ruptured eardrum -- also known as a perforated eardrum or a tympanic membrane perforation -can lead to complications such as middle ear infections and hearing loss. It may also require surgery
to repair the damage to the eardrum. Most perforated eardrums heal in a few weeks. Sometimes,
though, doctors need to do surgery to repair the tear.
What Is a Ruptured Eardrum?

A ruptured eardrum is a tear in the thin membrane that separates your outer ear from your inner ear.
That membrane, known as the tympanic membrane, is made of tissue that resembles skin.
The eardrum serves two important functions in your ear. It senses vibrating sound
waves and converts the vibration into nerve impulses that convey the sound to
your brain. It also protects the middle ear from bacteria as well as water and foreign
objects. Normally, the middle ear is sterile. But when the eardrum is ruptured, bacteria
can get into the middle ear and cause an infection known as otitis media.
What Causes a Ruptured Eardrum?

A number of things can cause the eardrum to rupture; one of the most common causes
is an ear infection. When the middle ear is infected, pressure builds up and pushes
against the eardrum. When the pressure gets too great, it can cause the eardrum to
perforate. When that happens, you may suddenly notice that the pain and pressure
you've felt from the infection suddenly stops and pus drains from the ear.
Another common cause of a ruptured eardrum is poking the eardrum with a foreign
object, such as a cotton-tipped swab or a bobby pin that's being used to clean wax out
of the ear canal. Sometimes children can puncture their own eardrum by putting objects
such as a stick or a small toy in their ear.
Some ruptured eardrums result from what's known as barotrauma. This happens when
the pressure inside the ear and the pressure outside the ear are not equal. That can
happen, for example, when an airplane changes altitude, causing the air pressure in the
cabin to drop or rise. The change in pressure is also a common problem for scuba
divers.
A head injury or an ear slap can cause the eardrum to rupture. So can an acoustic
trauma caused by a sudden loud noise, such as an explosion or a sudden blast of loud
music.
What Are the Symptoms of a Ruptured Eardrum?

Some people don't notice any symptoms of a ruptured eardrum. Others see their doctor
only after several days of general discomfort in their ear and feeling that "something's
not quite right with the ear." Some people are surprised to hear air coming out their ear
when they blow their nose. Forcefully blowing your nose causes air to rise up to fill the
space in your middle ear. Normally this will cause the eardrum to balloon outward. But if
there is a hole in the eardrum, air will rush out. Sometimes the sound is loud enough for
other people to hear.
Other symptoms of a ruptured eardrum include:
Sudden sharp ear pain or a sudden decrease in ear pain

Drainage from the ear that may be bloody, clear, or resemble pus
Ear noise or buzzing
Hearing loss that may be partial or complete in the affected ear
Episodic ear infections
Facial weakness or dizziness
How Is a Ruptured Eardrum Diagnosed?
If you have any of the symptoms of a ruptured eardrum, the doctor will do an
otoscopic exam. An otoscope is an instrument with a light that's used to look
inside the ear. In most cases, if there is a hole or tear in the eardrum, the doctor
will be able to see it.
Sometimes there may be too much wax or drainage for the doctor to clearly see
the eardrum. If this is the case, the doctor may clean the ear canal or prescribe
eardrops for you to use to help clear it. Sometimes, the doctor uses a rubber bulb
attached to the otoscope to blow a puff of air into the ear. If the eardrum is not
ruptured, it will move when the air hits it. If it is ruptured, it won't.
The doctor may also test your hearing to determine how much effect the ruptured
eardrum has had on your hearing; he or she may use a tuning fork to test it. The
doctor may also ask for an audiology test, which uses a series of tones you listen
to with headphones to determine your level of hearing. Most hearing loss due to
a ruptured eardrum is temporary. Normal hearing returns usually after the
eardrum heals.
How Is a Ruptured Eardrum Treated?

Typically, no specific treatment is needed for a ruptured eardrum; the vast majority of
ruptured eardrums heal within three months. Your doctor may prescribe an antibiotic -either oral or in the form of eardrops -- to prevent an ear infection or treat an existing
infection. If the ruptured eardrum is causing you pain, the doctor may recommend using
an over-the-counter pain medication such as acetaminophen or ibuprofen. Warmth may
be applied also to relieve discomfort.
If the eardrum is slow to heal, the doctor may put a patch over the eardrum. In some
cases, surgery may be needed to repair a ruptured eardrum. The surgery is usually
done on an outpatient basis. During the procedure, which usually takes a couple of
hours, the doctor will attach a piece of your own tissue to the eardrum to rebuild the
eardrum. Surgery is most commonly used for large perforations, for perforations that
involve the edges of the eardrum, or for ruptured eardrums caused by an ear infection.
While the eardrum heals, you'll need to keep the ear dry. That means no swimming or
diving until the doctor says the eardrum is healed. You'll also need to use a shower cap
or place cotton coated with petroleum jelly in your outer ear when you shower to keep
water out. Other precautions include:
Not using medicine other than what's prescribed by your doctor in your ear
Taking all the medicine prescribed by the doctor
Protecting the ear from cold air
Avoiding blowing your nose while the ear heals
Prevention:
Keep your ear dry to prevent further infection.

Gently stuff your ears with cotton when you bathe to
prevent water from entering the ear canal.
Avoid swimming until your ear heals.
If you get an ear infection, get it treated right away.
Try to avoid flying in airplanes when you have a cold
or sinus infection.
Use earplugs, chew gum, or force a yawn to keep
your ear pressure stabilized.
Dont use foreign objects to clean out extra earwax
(showering every day is usually enough to keep your
earwax levels balanced).
Wear earplugs when you know that youll be exposed
to a lot of noise, such as around loud machines or at
concerts and construction sites.

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Perforated Eardrum

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Perforated Eardrum

The eardrum and hearing

What Is a Ruptured Eardrum?

What Causes a Ruptured Eardrum?

What Are the Symptoms of a Ruptured Eardrum?

Sudden sharp ear pain or a sudden decrease in ear pain

How Is a Ruptured Eardrum Diagnosed?

How Is a Ruptured Eardrum Treated?

Keep your ear dry to prevent further infection.

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