A ruptured eardrum can occur unexpectedly. You may experience ear pain or ear pain that has been going away for some time and suddenly goes away.

You may also have no signs that your eardrum is punctured.

A perforated eardrum – also called a pierced eardrum or perforation of the eardrum – can cause difficulties such as middle ear infections and hearing loss.

It may also require surgical treatment to repair damage to the eardrum. However, normally, especially if you protect your ear, a ruptured eardrum will heal on its own, without treatment, within a few months.

What is a pierced eardrum?

A perforated eardrum results from the tearing of a thin layer of membrane that separates your outer ear from your inner ear. This layer of membrane, called the tympanic membrane, is made up of cells that look like skin.

The eardrum has 2 important functions in your ear. It detects vibrating acoustic waves and converts resonance into nerve impulses that communicate sound to your brain.

It also protects the inner ear against microorganisms in addition to water. Normally, the middle ear is sterile.

However, when the eardrum punctures, microorganisms can enter the inner ear and cause an infection called otitis media.

What causes a ruptured eardrum?

A number of causes can trigger the eardrum; one of the most common reasons is an ear infection.

When the inner ear is infected, pressure builds up and presses against the eardrum.

When the tension becomes too strong, it can trigger the eardrum. When this happens, you can suddenly notice that the discomfort and pressure you felt during the infection stops instantly.

Another typical cause of a pierced eardrum is rubbing the eardrum with an object such as a cotton swab or an ear pick that is used to remove wax from the ear canal.

In some cases, young people can pierce their own eardrum by placing objects such as a stick or a small toy in their ear.

Some ruptured eardrums result from what is called barotrauma. This happens when the pressure inside the ear and the pressure outside the ear are not equal. This can happen, for example, when an aircraft adjusts the altitude, causing the air pressure in or out of the cabin to go down or up. Changing the pressure is also a typical problem for divers.

A head injury or a blow to the ear can cause a ruptured eardrum. The same is true for an acoustic injury caused by an abrupt and loud noise, such as a surge, an explosion or loud songs.

What are the symptoms of a pierced eardrum?

Some people do not notice any signs of a pierced eardrum. Others only see their ENT after a certain number of days of discomfort in the ear and after having the impression that “something is not behaving normally in the ear canal”.

Some people are surprised to hear air coming out of their ear when they blow their nose. Blowing your nose vigorously causes the air to rise to fill the inner ear area.

Various other signs and symptoms of a broken eardrum include:

  1. Sudden acute ear pain or sudden decrease in ear discomfort.
  2. Drip from the ear, clear or look like pus.
  3. Ear noises or ringing in the ears.
  4. Hearing loss which may be partial or complete in the affected ear.
  5. Temporary ear infections.
  6. Fatigue or feeling dizzy
How is a pierced eardrum diagnosed?

If you have any of the symptoms of a pierced eardrum, the doctor will do an otoscopic test.

An otoscope is a tool with a light that is used to look inside the ear.

In most cases, if there is a hole or tear in the eardrum, the ENT surely can see it.

How is a perforated eardrum treated?

Generally, no specific therapy is necessary for a perforated eardrum; the vast majority of pierced eardrums recover within 3 months. Your doctor may prescribe an antibiotic or ear drops to prevent ear infections or treat an existing infection.

If the eardrum is causing you discomfort, your doctor may suggest using an over-the-counter pain reliever like acetaminophen or Advil.

Heat can also be used to relieve pain.

If the eardrum heals slowly, you may be referred to an ENT who takes care of the ears, nose, and throat.

In some cases, surgery may be necessary to repair a pierced eardrum.

The intervention is generally done on an outpatient basis. Throughout the operation, which normally takes a few hours, the doctor will attach a piece of your own cells to the eardrum to rebuild the eardrum. Surgical treatment is most often used for large openings, for openings that involve the edges of the eardrum, or for perforation of the eardrum caused by an infection of the ear.

During the healing of the eardrum, you will need to keep the ear completely dry.

This implies that you should not swim or dive until the ent has confirmed that the eardrum is completely healed.

Likewise, you will need to use a bathing cap or earplugs when taking your shower to keep water out of the ear canal.

Other preventive measures may apply:

  • Do not use medicines other than those prescribed by your healthcare practitioner in your ear.
  • Take all medications prescribed by the doctor
  • Protect the ear from cold air
  • Avoid blowing your nose while the ear is healing.
How to protect a pierced eardrum against a new perforation of the eardrum?

The two crucial steps you can take to protect yourself from a pierced eardrum are to avoid placing any type of object in your ear, to clean it, and to treat ear infections immediately.

It is also important to see a doctor to remove an external object from your ear rather than trying to remove it yourself.