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A ruptured, or perforated, eardrum prevents the proper transmission of sound waves to the middle ear and leaves the middle ear vulnerable to infectious agents, water and other foreign substances. Call your doctor if you experience any of the signs or symptoms of a ruptured or perforated eardrum or pain or discomfort in your ears. If your eardrum ruptures, complications can occur while your eardrum is healing or if it fails to heal.
Ear canal debris normally travels to your outer ear with the help of ear-protecting earwax. A cholesteatoma provides a friendly environment for bacteria and contains proteins that can damage bones of your middle ear.
If you have signs or symptoms of a perforated eardrum, you're likely to start by seeing your family doctor or general practitioner.
If you think you have signs or symptoms of a ruptured eardrum, you may want to ask your doctor some of the following questions. If I have a ruptured eardrum, what do I need to do to protect my ear during the healing process?
If you think that you have a ruptured eardrum, be careful to keep your ears dry to prevent infection.
Don't put medication drops in your ear unless your doctor prescribes them specifically for infection related to your perforated eardrum. Your family doctor or ENT specialist can often determine if you have a perforated eardrum with a visual inspection using a lighted instrument (otoscope). He or she may conduct or order additional tests to determine the cause of the rupture or degree of damage.
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Your middle and inner ears are composed of delicate mechanisms that are sensitive to injury or disease. Barotrauma is stress exerted on your eardrum when the air pressure in your middle ear and the air pressure in the environment are out of balance. Severe injury, such as skull fracture, may cause the dislocation or damage to middle and inner ear structures, including your eardrum.


The middle ear is separated from your external ear by the eardrum and connected to the back of your nose and throat by a narrow passageway called the eustachian tube. When sound waves strike it, your eardrum vibrates — the first step by which structures of your middle and inner ears translate sound waves into nerve impulses.
Your eardrum also acts as a barrier, protecting your middle ear from water, bacteria and other foreign substances. Usually, hearing loss is temporary, lasting only until the tear or hole in your eardrum has healed. If your eardrum is ruptured, the skin debris can pass into your middle ear and form a cyst. However, your doctor may refer you to a specialist in ear, nose and throat disorders (ENT physician or otolaryngologist). If there's discharge from your ear, your doctor may order a laboratory test or culture to detect a bacterial infection of your middle ear.
A tympanometer uses a device inserted into your ear canal that measures the response of your eardrum to slight changes in air pressure. If other hearing tests are inconclusive, your doctor may order an audiology exam, a series of strictly calibrated tests conducted in a soundproof booth that measure how well you hear sounds at different volumes and pitches.
If the tear or hole in your eardrum doesn't close on its own, an ENT specialist may seal it with a patch. If a patch doesn't result in proper healing or your ENT determines that the tear isn't likely to heal with a patch, he or she may recommend surgery. Place a waterproof silicone earplug or cotton ball coated with petroleum jelly in your ear when showering or bathing. Be aware of the signs and symptoms of middle ear infection, including earache, fever, nasal congestion and reduced hearing.
If possible, don't fly if you have a cold or an active allergy that causes nasal or ear congestion. Never attempt to dig out excess or hardened earwax with items such as a cotton swab, paper clip or hairpin.
Protect your ears from unnecessary damage by wearing protective earplugs or earmuffs in your workplace or during recreational activities if loud noise is present.


This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. If a perforated eardrum doesn't heal or isn't repaired, you may be vulnerable to ongoing (chronic) infections that can cause permanent hearing loss. To keep water out of your ear when showering or bathing, use a moldable, waterproof silicone earplug or put a cotton ball coated with petroleum jelly in your outer ear. If the tear or hole in your eardrum doesn't heal by itself, treatment will involve procedures to close the perforation.
With this office procedure, your ENT may apply a chemical to the edges of the tear to stimulate growth and then apply a patch over the hole. During takeoffs and landings, keep your ears clear with pressure-equalizing earplugs, yawning or chewing gum. Barotrauma is also called airplane ear because it's most often caused by air pressure changes associated with air travel. A tuning fork evaluation may also reveal whether hearing loss is caused by damage to the vibrating parts of your middle ear (including your eardrum), damage to sensors or nerves of your inner ear, or damage to both.
Seek prompt evaluation from your primary care doctor to prevent potential damage to the eardrum.
Or use the Valsalva maneuver — gently blowing, as if blowing your nose, while pinching your nostrils and keeping your mouth closed. Teach your children about the damage that can be done by putting foreign objects in their ears.
This procedure is done on an outpatient basis, meaning you can usually go home the same day unless medical anesthesia conditions require a longer hospital stay.



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