Tympanic Membrane Perforation

A ruptured eardrum is a hole or tear in your eardrum or tympanic membrane, the thin tissue that separates your ear canal and middle ear. Because the eardrum’s function is to help make sound louder by vibrating the small middle ear bones, a perforated tympanic membrane is often accompanied by decreased hearing or the sensation that the hearing is “hollow”. Occasionally, a perforated eardrum can also give the paradoxical sensation of ear fullness.

The causes of a perforated eardrum range from infections of the middle ear (otitis media) to traumatic injury such as that caused by cotton swab use. Sudden pressure changes of the ear canal that occur while scuba diving or skydiving, loud explosions, or skull fractures can also cause a rupture of the eardrum. Pain may accompany the initial injury but is usually not persistent. Middle ear infections may cause pain, hearing loss, and spontaneous rupture of the eardrum. In these cases, the patient may note infected or bloody drainage from the ear. In medical terms, this is called otitis media with perforation.

Generally, larger perforations lead to greater amounts of hearing loss. With traumatic eardrum ruptures, the three small bones in the middle ear (ossicles) may also be dislocated leading to greater amounts of hearing loss.

The majority of ruptured eardrums heal spontaneously within weeks, although some may take up to several months. Occasionally, your physician may place a small piece of artificial material or patch over the hole to facilitate the healing process. This procedure is not painful and can be done in the office with cooperative patients. During the healing process, the ear must be protected from water and additional trauma.

In the cases where the eardrum does not heal, a surgical procedure (tympanoplasty) may be required to permanently fix the hole. The surgery is minimally invasive and can be completed quickly on an outpatient basis. Surgery is recommended for patients to improve hearing, prevent infections, and provide the ability to swim and bathe without protecting the ear. In some cases, the development of cholesteatoma (a benign skin cyst in the ear) may necessitate surgical intervention.

If you or your child have been diagnosed or suspect a ruptured eardrum, contact Denver Ear to schedule a consultation. If the tympanic membrane is perforated, it is wise to ensure the ear heals properly to prevent further difficulties.

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