Perforated Eardrum

perforated ear drum

The eardrum (also called the tympanic membrane) is a thin skin-like structure in the ear. It lies between the outer and middle ear. The ear is divided into three parts - the outer, middle, and inner ear. Sound waves come into the outer (external) ear and hit the eardrum, causing the eardrum to vibrate. Behind the eardrum are three tiny bones (ossicles). The vibrations pass from the eardrum to these middle ear bones. The bones then transmit the vibrations to the cochlea in the inner ear. The cochlea converts the vibrations to sound signals which are sent down a nerve to the brain, which we 'hear'.

What is a perforated eardrum and what problems can it cause?

A perforated eardrum is a hole or tear that has developed in the eardrum. It can affect hearing. However, the extent of hearing loss can vary greatly. For example, tiny perforations may only cause minimal loss of hearing. Larger perforations may affect hearing more severely.

Also, with a perforation, you are at greater risk of developing an ear infection. This is because the eardrum acts as a barrier to bacteria and other germs that may get into the middle ear.

What can cause a perforated eardrum?

Causes include:

  • Infections of the middle ear, which can damage the eardrum.
  • Direct injury to the ear. For example, a punch to the ear.
  • A sudden loud noise. For example, from a nearby explosion. The shock waves and sudden sound waves can perforate the eardrum.
  • Barotrauma. This is when you suddenly have a change in air pressure and there is a sharp difference in the pressure of air outside the ear and in the middle ear. For example, when descending in an aircraft.
  • Poking objects into the ear. This can sometimes damage the eardrum.

How is a perforated eardrum diagnosed?

A doctor can usually diagnose a perforated eardrum simply by looking into the ear with a special torch called an otoscope.

What is the treatment for a perforated eardrum?

No treatment is needed in most cases

A perforated eardrum will usually heal by itself within 6-8 weeks. It is a skin-like structure and, like skin that is cut, it will usually heal. In some cases, a doctor may prescribe antibiotics if there is an infection or risk of infection developing in the middle ear whilst the eardrum is healing.

It is best to avoid water getting into the ear whilst it is healing.

Surgical treatment is sometimes considered

A small procedure is an option to treat a perforated drum that does not heal by itself. There are various techniques ranging from placing some chemicals next to the torn part of the drum to encourage healing, to an operation called tympanoplasty to repair the eardrum. Tympanoplasty is usually successful in fixing the perforation, and improving hearing.

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