The most common cause of tympanic membrane perforation is an ear infection, also called otitis media. Ear infections cause pressure build-up in the middle ear, which exerts force on the eardrum. When the pressure becomes too great, the eardrum will rupture or perforate. If you’ve had ear pain related to an ear infection and experience a popping noise followed by fluid or pus drainage, it’s likely that you have a perforated eardrum.

Another cause of perforated eardrums is physically poking the eardrum with a cotton swab or other foreign object when cleaning wax from the ear canal. You should never fully insert a cotton swab or any other object into the ear canal, with the biggest risks being impacted earwax and/or a perforated eardrum. Head injuries, acoustic trauma, and extreme barometric changes can also cause the tympanic membrane to rupture. It is an extremely sensitive barrier between the outside elements and your delicate middle ear, and protecting it is necessary to maintain our ability to hear properly.

Signs & Symptoms
Oftentimes, people may not realize that they ruptured their eardrum. It’s common for patients to know something isn’t quite right, but the symptoms may not impede their day-to-day function. Some will seek treatment, but even for those that don’t the membrane will typically heal on its own. For severe cases or for slow-healing patients, surgical revision may be required.
Common symptoms of a perforated ear drum include sharp ear pain, sudden relief of existing ear pain, drainage of fluid or pus, ringing or buzzing in the ears, ear infection, dizziness or other balance issues, and/or hearing loss.

A hole in the tympanic membrane can sometimes be heard using the Valsalva maneuver. To perform this test, you can hold your breath and force air through the eustachian tubes of the ears from the back of the nasal cavity. This air opens the tubes and exerts pressure on the eardrum. If it is perforated, the eardrum may make an audible whistling noise.

Treatment Options
Most perforated eardrums will heal on their own within a few weeks. During this time, over the counter medication can help to relieve pain or discomfort. A warm compress can also help to alleviate pain. If your ruptured eardrum is a result of an ear infection, your doctor will likely prescribe you antibiotics to help clear the infection. Avoid swimming, diving, or submerging the ears until the eardrum is completely healed to prevent water intrusion into the middle ear. Use a waterproof cap to avoid getting the ear canal wet during showers.

Surgical Repair
For severe cases or large tears, a tympanoplasty may be required. This procedure usually requires general anesthesia and an overnight stay for observation. The surgery takes approximately 2 hours and can be performed through an incision either in the ear canal or behind the ear. Once the anesthesia takes full effect, your surgeon will create a small incision in the fold behind the ear to expose the eardrum. The area is cleaned, and a graft is taken from the tissues around the ear. Tympanoplasty has a high success rate, around 85%-90%.

Tympanic membrane perforation is a common condition that can be treated by our experienced team. If you’ve experienced a ruptured eardrum, contact Acadian Ear, Nose, Throat, & Facial Plastics today via phone at (337) 237-0605 to schedule your initial evaluation.