Tympanic Membrane Perforation

About Tympanic Membrane Perforation

Tympanic Membrane Perforation is the term for what may also be referred to as a punctured eardrum or a ruptured eardrum. It occurs when there is a tear in the thin membrane. This tympanic membrane separates the outer ear from the inner ear. It can happen suddenly, causing a sharp pain, or present as an earache that goes away.

The most frequent cause of a ruptured eardrum is a middle ear infection, which causes the pressure in the ear to build to the point that it can perforate the eardrum. The pain and pressure may suddenly feel relieved, followed by drainage from the ear.

Foreign objects being poked into the ear are another frequent cause of a perforated eardrum. Cotton-tipped swabs or bobby pins being used to clean the ear canal of wax, or in the case of young children, a sharp stick or toy, can cause a perforation of the tympanic membrane.
Extreme air pressure differences can lead to a perforated eardrum, such as from scuba diving or a sudden, sharp descent in an airplane. Occasionally, head injuries or a sudden loud sound can cause the eardrum to rupture.

Some people describe a discomfort in the ear following a perforation while others have no symptoms. Blowing your nose may lead to the diagnosis, as air fills the middle ear and can be felt – or sometimes even heard – to rush out. Other symptoms may include sharp ear pain or a sudden decrease in ear pain; bloody, clear or pus-like drainage; noise or buzzing in the ear; hearing loss; and other symptoms.
Diagnosis from an ENT specialist includes an otoscopic exam in which a puff of air may be directed into the ear. If the eardrum is ruptured, the tympanic membrane will not have movement. Ruptured eardrums will heal in about three months. An ear nose and throat specialist may prescribe antibiotic eardrops or oral medications if an ear infection is present. Over-the-counter pain medication may be used for discomfort.

Surgery by an otolaryngologist may be considered if the eardrum is not healing properly or has a large perforation using a patch of your own tissue to rebuild the eardrum.

During the healing after a ruptured eardrum, the ear must be kept dry, so swimming is prohibited. A shower cap or cotton ball coated with petroleum jelly should be used during bathing. Other precautions should include, protecting the ear from cold and strenuously blowing your nose.