Perforated Eardrum - A guide to Hearing Loss

A perforated ear drum is a condition in which the ear drum becomes torn or splits as a result of an ear infection, the insertion of a foreign body into the ear or a dramatic change in air pressures within the ears. The degree of perforation can range from a tiny hole through to a large tear.

Causes of a perforated ear drum

The most likely cause of a perforation is an ear infection. During an ear infection fluid builds up in the outer and middle ear which then puts pressure on the ear drum. As more and more fluid appears this stresses the ear drum to the extent that it rips or splits.

A lesser known cause is that of a foreign body. Children especially enjoy exploring areas of their body which usually involves the insertion of an object or two. The most popular places for this are the nose and ears. So if you are a parent of a young child then don’t be surprised if you find a small toy or household object in there! This isn’t usually a problem as they either remove this object themselves or the object in question makes its own way out.

But in a few cases the object has been pushed that far down into the ear that it requires medical intervention to remove it.

This is discussed in more detail in our foreign body in the ear section. This can happen with adults as well. A common scenario is that where someone uses a cotton wool bud or a hair pin to clean out wax from their ear but this then forces the wax deeper into the ear. Or the excessive force punctures the ear drum.

This is why healthcare professionals advise you against using cotton wool buds to clean your ears. Learn more about this in our ear wax section. Another factor is that where there is a change in air pressures within the ear. These air pressures maintain equilibrium so that sounds can pass as normal through the ear but if they suddenly build up then this puts a strain on the ear drum which causes it to split.

Exposure to extremely loud noises such as an explosion can also damage the ear drum. But this tends to be rare.

Symptoms of a perforated eardrum

If this happens suddenly then the first thing you will notice is pain, hearing loss and earache.

If the condition has been caused by the presence of a foreign body then these symptoms may be accompanied by a discharge or bleeding from the ear. Mucus, infectious liquid or pus is likely to be discharged from the ear in the case of an ear infection. If the perforation has been caused by a head cold then it will be joined by other all too familiar symptoms such as headaches, aches and pains, nasal congestion, sneezing and a temperature. If a loud noise is responsible for the perforation then it may be followed by tinnitus although this will be a temporary situation.

Treatment for a perforated ear drum

In most cases a perforated ear drum will heal of its own accord.

It’s a good idea to ask your GP to check the condition of your perforation after a couple of weeks to see if treatment such as antibiotics is required.

If the perforation hasn’t healed or is especially large then surgery may be the only answer. A procedure called a myringoplasty is carried out in which a skin graft, taken from another part of the ear, is grafted over the perforation.