Article by Hearing Partners, contributed by Nur Azren, Clinical Audiologist at Hearing Partners
The eardrum is a thin membrane located at the end of the ear canal separating the outer ear from the middle ear. Aside from detecting and transmitting sound, the eardrum acts as a barrier, protecting the middle ear from bacteria, water, and foreign objects.
When the eardrum ruptures, you may experience symptoms such as sudden ear pain, drainage of fluid from the ear, and hearing loss. This article will delve into the causes and symptoms of a ruptured eardrum, and explore treatment options and preventive measures.
Symptoms of a Ruptured Eardrum
A ruptured eardrum can present via a range of symptoms that vary in intensity. The following point to a possible ruptured eardrum:
- Sudden sharp pain
- Ringing in the ears (tinnitus)
- Hearing loss
- Ear discharge that’s clear, bloody or with pus
- Vertigo (sensation of the surroundings spinning or moving)
- Nausea and vomiting
Causes of a Ruptured Eardrum
Various factors can compromise the integrity of the eardrum. This section will cover the possible causes of a ruptured eardrum.
Otitis media (middle ear infection)
Otitis media is a middle ear infection, often resulting from bacteria or viruses. This condition leads to the accumulation of fluid and pus behind the eardrum. If the pressure from the fluid buildup becomes too great, it can cause the eardrum to stretch and eventually rupture.
Ear barotrauma
Ear barotrauma is a condition that occurs when there is a large difference in pressure between the outside environment and the middle ear. This often happens during activities such as air travel or scuba diving.
When the pressure changes rapidly, the Eustachian tube may struggle to equalise the pressure in the middle ear. If the pressure imbalance becomes too extreme, the eardrum may rupture from overstretching.
Trauma to the head or ear
Trauma to the head or ear may occur due to severe collisions, such as sports or motor accidents. This trauma can dislocate or damage the structures within the middle and inner ear, including the eardrum. The eardrum may even be directly punctured.
Foreign objects in the ear canal
Foreign objects in the ear canal can lead to a ruptured eardrum through direct impact or pressure. Common examples of items that may be inserted into the ear include small toys, beads, or cotton swabs. When these objects are pushed too far into the ear canal, they can create excessive pressure against the eardrum, causing it to stretch and rupture.
Loud sounds
Extremely loud sounds, such as gunshots, fireworks, explosions, or amplified music at high volumes, can reach harmful decibel levels. Such intense sounds can cause a ruptured eardrum by forcing the eardrum to stretch excessively.
Diagnosing a Ruptured Eardrum
Diagnosing a ruptured eardrum involves a comprehensive evaluation by a medical professional. In this section, we’ll explore the two commonly used methods of diagnosis.
Otoscopy
During an otoscopy examination, an Ear, Nose and Throat (ENT) doctor will use an otoscope to inspect the ear canal and eardrum. They’ll look for signs of infection, fluid accumulation, or abnormalities such as perforations in the eardrum.
In addition to a visual inspection, the doctor may conduct a pneumatic otoscopy. In this procedure, a rubber bulb is attached to the otoscope, allowing the doctor to blow air into the ear. If the eardrum is intact, it’ll vibrate in response to the air pressure. Conversely, if it’s ruptured, the eardrum won’t respond.
Hearing test
Two types of hearing tests may be carried out to diagnose the severity of the ruptured eardrum — tympanometry and an audiometry test.
Tympanometry measures the movement of the eardrum in response to changes in air pressure. This test helps evaluate the extent of damage to the eardrum.
On the other hand, audiometry evaluates your overall hearing ability through various tones and frequencies. During this test, you’ll listen to sounds through headphones and indicate when you hear them. Audiometry helps quantify the degree of hearing loss associated with the ruptured eardrum and identifies specific frequencies affected by the injury.
Treatment for a Ruptured Eardrum
A ruptured eardrum often heals on its own. However, if it doesn’t heal naturally or complications arise, medical treatment is necessary to prevent further issues and restore hearing.
The treatment method commonly recommended for a ruptured eardrum is tympanoplasty. This surgical procedure involves repairing the eardrum by grafting a small piece of tissue over the perforation. The surgery aims to restore the integrity of the tympanic membrane, improve hearing and prevent chronic infections.
How to Prevent a Ruptured Eardrum
Preventing a ruptured eardrum involves taking proactive measures to protect your ears from potential risks. By implementing these practices, you can significantly reduce the likelihood of an ear injury in the future.
- Protect your ears from loud noises: Wear earplugs or other protective gear in environments where you might be exposed to loud sounds. Examples of these sounds include gunshots or explosions.
- Avoid inserting foreign objects into your ear: Avoid using cotton swabs to clean your ears as this can easily lead to a ruptured eardrum. Instead, gently wipe the outer ear with a clean cloth.
- Avoid barotrauma: To prevent barotrauma, try yawning, chewing gum, or using special earplugs designed to equalise pressure.
- Seek treatment for otitis media: Symptoms of middle ear infections include earache, fluid discharge and difficulty hearing. Contact a healthcare provider if these symptoms persist for a few days to avoid complications like a ruptured eardrum.
FAQs About a Ruptured Eardrum
When should I see a doctor for a ruptured eardrum?
Seek immediate attention from an ENT doctor if your ruptured eardrum is due to a foreign object lodged in your ear canal. The doctor will safely remove the object from your ear without causing further complications.
Furthermore, if your symptoms persist for a few weeks without improvement, it’s advisable to consult an ENT specialist for further evaluation and treatment.
Are there any complications of a ruptured eardrum?
Some complications could arise from a ruptured eardrum, such as:
- Hearing loss: Typically temporary, hearing loss can occur until the eardrum heals, with the degree of loss dependent on the size and location of the tear.
- Otitis media: A ruptured eardrum can allow bacteria to enter, potentially leading to recurrent ear infections. In some cases, this can result in chronic drainage and ongoing hearing loss.
- Middle ear cyst (Cholesteatoma): Although rare, a cyst may form in the middle ear from skin debris entering due to the rupture. This cyst can create a conducive environment for bacteria and may damage the bones of the middle ear.
Can a ruptured eardrum heal on its own?
Yes, a ruptured eardrum can heal on its own, depending on the extent of the damage. However, if it doesn’t heal naturally, surgical intervention via tympanoplasty may be necessary.
Nur Azren is a Clinical Audiologist at Hearing Partners. She has a Degree in Audiology from the University Sains Malaysia (USM) and a Bachelor of Health Science with Honours (Audiology) from the University Sains Malaysia (USM). She has over 10 years of experience in audiology.