What's a Perforated Eardrum?

Turn that music down or you'll burst your eardrums!

Has anyone ever said that to you? You might have wondered if you really can burst an eardrum. Well, maybe not from playing the music too loud, but there are other causes.

The most common reason is an ear infection. Pus builds up behind the eardrum, also called the tympanic membrane, and it causes a tear.

Usually, the person feels a sharp pain, fluid drains out of the ear canal, and the person has some hearing loss, which is usually temporary. In some cases, a doctor may need to apply a patch or do surgery to repair the tear. But more often, the tear heals by itself and the person's hearing returns to normal in a few weeks.

The Eardrum "Ruptures" or "Perforates"

A hole in the eardrum is also called a ruptured or perforated eardrum. Something that has ruptured has broken. And perforation means a hole or holes. Maybe you've used perforated paper. It's the kind in a spiral notebook that tears out easily because of the holes along the left side.

To understand a torn eardrum, you first need to know how the ear works and what the eardrum is. It's sort of like a drum because it's a thin piece of skin-like tissue stretched tight across the opening between your outer ear canal and the middle ear.

Your outer ear funnels sound waves into your ear canal, where they hit your eardrum and make it vibrate. Your middle ear and inner ear convert the vibrations to signals that your brain interprets as sounds.

If there is a hole in the eardrum, it might not vibrate very well, which can make your hearing worse. Most people with a perforated eardrum get all their hearing back eventually.

A perforated eardrum also can allow bacteria to enter your middle ear. This can lead to an infection that can cause more hearing loss.

What Causes a Perforated Eardrum?

In addition to ear infections, you can tear your eardrum by poking something in your ear, even a cotton swab. They're really not needed to keep your ears clean.

Here are some other causes:

• Air pressure changes: When the air pressure changes, it can make your ears "pop." This is normal and often happens when flying in a plane or driving high into the mountains. But if the air pressure changes all of a sudden, it can cause a tear in the eardrum.
• Very loud noises, such as an explosion
• Head injuries that cause a fractured skull bone or a direct blow to the ear (like a slap)

How Do I Know if I Have a Torn Eardrum?

If your eardrum tears, you'll probably feel pain in your ear. Other signs that you might have a perforated eardrum include:

• fluid that can be clear, filled with pus, or bloody draining from your ear
• loss of hearing
• ringing or buzzing in your ear
• dizziness that can sometimes make you feel sick
• weakness in the muscles of your face (this doesn't happen a lot)

What Will the Doctor Do?

Tell a parent if you experience any of these problems. You'll want to have your doctor check it out. The doctor will look in your ear canal with a lighted instrument called an otoscope. Fluid or blood might block the doctor's view, but often, he or she will be able see the tear.

The doctor may take a sample of that fluid to test for infection. He or she might also do some tests to measure your hearing and how well your ears are working.

Most perforated eardrums will heal within a few weeks without any treatment. To help prevent or treat infections, the doctor may give you medicines called antibiotics that you take by swallowing, or ear drops your parent can give you. The doctor also might suggest a pain reliever if your ear hurts.

What Should I Do Until I'm Better?

Keep your ear dry while it heals. Your doctor might recommend avoiding swimming or using an earplug for the pool. To keep dry while showering, use a shower cap. You also can ask your doctor about how to use a cotton ball coated with petroleum jelly as an earplug.

It may be hard to do, but avoid forcefully blowing your nose until the tear in your eardrum is all the way healed.

How Can I Prevent a Torn Eardrum?

To protect your eardrums:

• Tell a parent if your ear is hurting you. You might have an infection and need to see the doctor.
• Never stick anything in your ear, even a cotton swab. If you get something stuck in your ear, have a doctor remove it.

Reviewed by: Steven P. Cook, MD
Date reviewed: September 2011