Ruptured Eardrum – Symptoms and Causes
Understanding Ear Injuries
A torn eardrum happens when the thin tissue between your ear canal and middle ear gets a hole or a tear. This tissue is called the tympanic membrane.
When damaged, you might experience hearing loss because sound waves can’t properly travel through your ear. The tear also leaves your middle ear open to infections since it no longer has its natural protection.
Most torn eardrums heal by themselves within a few weeks without any special treatment. However, some cases need medical help, like a patch or surgery, to fix the damage.
Signs You May Have a Ruptured Eardrum
People with a ruptured eardrum often feel ear pain that might go away quickly. You might notice fluid draining from your ear that looks like mucus, pus, or blood.
Hearing loss is common, along with ringing sounds in the ear (tinnitus). Some people experience:
- Spinning feelings (vertigo)
- Nausea
- Vomiting caused by vertigo
These symptoms may appear suddenly after an ear injury or infection.
When to See a Doctor
Contact your healthcare provider if you notice any signs that suggest your eardrum might be ruptured. The middle and inner parts of your ear contain sensitive structures that can be damaged easily.
Getting medical help quickly is important to:
- Find out what caused your ear symptoms
- Confirm if your eardrum has ruptured
- Prevent possible complications
Don’t delay seeking help if you experience ear pain, hearing changes, or drainage from your ear.
Causes
The middle ear contains three tiny bones (the hammer, anvil, and stirrup) that help transmit sound. When problems occur in this area, they can lead to eardrum rupture in several ways.
A common cause is middle ear infection. When infection develops, fluid builds up behind the eardrum. This fluid creates pressure that can eventually tear or burst the eardrum if it becomes too intense.
Pressure changes, known as barotrauma, also frequently damage eardrums. This happens when air pressure inside and outside the ear becomes unbalanced.
Common situations include:
- Airplane travel (especially during takeoff and landing)
- Scuba diving
- Direct blows to the ear
- Air bag deployment during car accidents
In rare cases, extremely loud noises or explosions can tear the eardrum through acoustic trauma. The powerful sound waves create enough force to damage the delicate membrane.
Foreign objects inserted into the ear canal represent another significant risk. Items like cotton swabs, hairpins, or other small objects can accidentally puncture the eardrum when pushed too far into the ear.
Severe head injuries, particularly those involving skull fractures, may also damage the eardrum and other structures within the middle and inner ear.
The middle ear connects to the throat and nasal passages through a narrow channel called the eustachian tube. This connection helps equalize pressure between the middle ear and the outside environment.
When this system fails to work properly, pressure imbalances can develop and potentially harm the eardrum.
Complications
When an eardrum ruptures and doesn’t heal naturally within three to six months, several problems may develop.
Temporary hearing issues often occur with a ruptured eardrum. The hearing loss typically lasts only until the tear heals. How much hearing is affected depends on both the size and location of the tear in the eardrum.
Infection risks increase when the eardrum is damaged. The rupture creates an opening that allows bacteria to enter the middle ear.
For most people, this isn’t a long-term problem. However, a small group of patients may experience:
- Ongoing (chronic) infections
- Persistent drainage from the ear
- Continued hearing problems
Middle ear cysts, also called cholesteatomas, represent a rare but serious complication. These cysts form when skin cells and debris collect in the middle ear due to the rupture.
Normally, the ear’s natural cleaning process moves debris outward with earwax, but a hole in the eardrum allows this material to move inward instead.
These cysts create problems in two ways:
- They provide an ideal environment for bacteria to grow
- They contain proteins that can damage the middle ear bones
The rupture itself may also enlarge if left untreated, potentially causing more significant hearing loss and increasing vulnerability to infections and other problems.
Prevention
Taking steps to prevent eardrum ruptures can save you from pain and hearing problems.
Here are several ways to protect your ears:
Treat Middle Ear Infections Promptly
- Watch for signs like earache, fever, congestion, and hearing changes
- Children with infections may be irritable and refuse food
- See a healthcare provider quickly when symptoms appear
Take Care During Air Travel
- Avoid flying when you have a cold or allergies causing congestion
- Use these techniques during takeoff and landing:
- Pressure-equalizing earplugs
- Yawning or chewing gum
- The Valsalva maneuver (gently blowing against closed nostrils)
- Stay awake during ascent and descent
Handle Ears Safely
- Never use cotton swabs, paper clips, hairpins or other objects to clean earwax
- These items can easily puncture the eardrum
- Teach children about the dangers of putting objects in their ears
Protect Against Loud Noises
- Wear protective earplugs or earmuffs during activities with explosive noises
- This includes certain hobbies, work environments, and recreational activities
