Perforated Eardrum

A perforated eardrum is a hole in the membrane that separates the ear canal from the middle ear. The most common cause of a perforated eardrum is infection. When the middle ear is infected, fluid can build up, stretching the eardrum until it bursts. This may (or may not) relieve the pain and will usually be accompanied by drainage from the ear canal.

Ear drums can also be perforated as a result of trauma, such as a blow to the ear, a sudden and loud noise, a skull fracture, or pushing an object into the ear canal. Other causes include:

• Slaps to the ear (for example, a hand slap to the side of the head)
• Changes in air pressure during flying or diving
• Sharp objects or even cotton-tipped swabs
• Car accidents
• Falls
• Sports injuries

In most cases, eardrum perforations heal themselves within a few weeks, however, some may take a few months. During this time, care should be taken to prevent water from entering the ear as well as avoiding additional trauma.

Hearing and perforated eardrums

Hearing is affected when an eardrum is perforated. How much it is affected depends on where the perforation is, as well as how large the perforation is. Often this depends on what caused the perforation. Severe injuries, like skull fractures, can actually cause problems with the small bones of the inner ear that transmit sound to the brain. In this case, hearing loss can be significant. In the case of a sudden and loud noise, such as an explosion, you can experience significant hearing loss as well as tinnitus.

Treatment

If the perforation is small, Dr. Alexander may monitor it over time to ensure it is closing on its own. If it is larger, he may patch it using special chemicals that stimulate growth on the edges of the perforation and placing a tiny paper patch over the hole itself. By closing the hole, hearing should be improved, and the eardrum and inner ear may be better protected from water. A patch may need to be applied more than once.

Occasionally, surgery is required if a perforation does not heal on its own or if the applied patches are not working. This surgery, known as tympanoplasty, places several small tissues over the perforation and is done in the office.