Diagnosis
If your child has symptoms of a ruptured or perforated eardrum, call a doctor right away. Most injuries will heal on their own, but you should ensure that any hearing loss is only temporary.
Also seek medical care right away if your child has severe symptoms, such as bloody discharge from the ear, extreme pain, total hearing loss in one ear, or dizziness that causes vomiting.
To check for ruptured or perforated eardrum, the doctor will examine your child's ear canal with a lighted tool called an otoscope. Sometimes the doctor will be able to see the tear in the eardrum, but other times fluid in the ear will block the view.
The doctor might order other tests to check for hearing loss, such as:
- audiology exams that measure how well someone hears sounds at different pitches and volumes
- tympanometry to measure the response of the eardrum to slight changes in air pressure
If there is fluid leaking from the ear, the doctor might send a sample for testing to see if there is an infection of the middle ear or inner ear.
Treatment
Usually, eardrum injuries heal on their own within a few weeks without any treatment. While the eardrum is healing, over-the-counter pain relievers can help ease any pain. Ask your doctor about which pain relievers are best for your child.
To help prevent infections or treat an existing infection, the doctor may prescribe antibiotics. These may be liquid or pills to be swallowed or ear drops. Never give your child over-the-counter ear drops unless your doctor recommends it. Some drops are not meant to be used if there is a hole in the eardrum because they can cause problems with the middle ear or cochlea.
To protect the eardrum while it heals, your doctor may advise keeping your child's ear dry. Tell your child to keep his or her head above water while swimming, and gently place a waterproof earplug or cotton ball coated with petroleum jelly in the ear when your child showers or bathes. Children also should not forcefully blow their noses until the eardrum is completely healed.
If a ruptured or perforated eardrum doesn't heal on its own within about 4 weeks, a child might need to see a pediatric otolaryngologist or ENT (ear, nose, and throat doctor). After an exam and hearing testing, the otolaryngologist or ENT may recommend an eardrum patch. During this procedure, a chemical is applied to the edges of the rupture to stimulate growth and healing, then a paper patch is placed over the area to protect it. This might have to be done a few times before the eardrum is fully healed.
If all other treatments fail, a specialist might perform a surgery known as a tympanoplasty. In this procedure, a small patch of a child's own tissue is grafted onto the affected eardrum to close the tear. This is a relatively simple surgery, and kids usually can leave the hospital the same day.