Eardrums are important, playing two vitally important roles in hearing. First they vibrate in response to sound waves. Second they create a barrier that safeguards the inner ear from infection. If your eardrum is fully intact, your inner ear is a safe and sterile environment; but once it has been punctured or torn, microbes can enter and cause a serious infection generally known as otitis media.

The terms ruptured eardrum and perforated eardrum mean the same thing. They both reference a condition whose technical name is a tympanic membrane perforation where there is a puncture or tear in the very thin membrane we know as the ear drum. There a variety of ways that an eardrum may become perforated, the most common of which is an ear infection where the resulting buildup of fluid pushes against the eardrum until it tears. Some people perforate their own eardrums by inserting foreign objects into the ears, for example the use of cotton swabs to remove ear wax. Barotrauma is yet another potential cause of a punctured ear drum. When the pressure inside the ear is very different than the pressure outside the ear – lower or higher – the eardrum may not be able to withstand the pressure difference and ruptures. Flying and scuba diving are a couple of occasions where this is prone to occur. Loud noises and explosions can also cause perforated ear drums. This phenomenon is known as acoustic trauma.

Indications of perforated eardrums include:

• Pain in the ear
• Loss of hearing in the affected ear
• Vertigo or dizziness
• Fluid draining from the ear

If you encounter any of these signs and symptoms, see a hearing health provider, because if the eardrum is ruptured, immediate and correct treatment is important to prevent hearing damage and infection. Untreated, a ruptured eardrum can result in middle and inner ear infections, middle ear cysts (cholesteatoma), and permanent hearing loss.

At your appointment the specialist will view the eardrum with an instrument called an otoscope. Because of its internal light, the otoscope gives the doctor a clear look at the eardrum. Perforated eardrums generally heal on their own in 8 to 12 weeks. During this time period, your healthcare provider will most likely advise you to avoid diving and swimming and to refrain from blowing your nose as much as possible. It’s also advisable to avoid any non-essential medications. If the puncture or tear is close to the edge of the eardrum, the health care provider can help the healing process by placing a temporary dam or patch to help reduce the risk of infection, or even propose surgery.

Any remaining pain or discomfort can be handled using over-the-counter (OTC) pain medications such as acetaminophen or ibuprofen. Not every perforated eardrum can be prevented, but there are things you can do to reduce your risk. Always get immediate treatment for any ear infections and never put any foreign objects into your ear (even for cleaning).