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The eardrum is necessary for hearing because it detects sound waves and conveys the vibrations to the brain, but it also acts as a shield to isolate the inner ear and keep it free from infection. If your eardrum is fully intact, your inner ear is basically a sterile and protected place; but if it has been punctured or torn, harmful bacteria can get in and start a serious infection generally known as otitis media.

The terms perforated eardrum and ruptured eardrum mean the same thing. They each reference a problem whose medical 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 are various causes of perforated ear drums. The most prevalent is an inner ear infection. Fluid at the site of the infection presses up against the membrane, increasing pressure until it finally tears. Another well-known reason for ruptured eardrums are foreign objects introduced into the ears. For instance, it is possible to rupture your own eardrum with a Q-tip. An additional well-known cause is barotrauma – the circumstance that happens when the barometric pressure inside the ear is different from the pressure outside the ear – which can occur while scuba diving or flying. Sudden loud noises and explosions can also cause punctured ear drums. This 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 experience any of these signs and symptoms, see a specialist, because if the eardrum is ruptured, timely and appropriate treatment is essential to prevent infection and hearing damage. Untreated, a punctured eardrum can lead to middle and inner ear infections, middle ear cysts, and permanent loss of hearing.

Perforated eardrums are diagnosed in a doctor’s office using a tool called an otoscope, which has an internal light which allows the specialist to view the eardrum clearly. Punctured eardrums normally heal by themselves in 2 to 3 months. During this time, the doctor will most likely counsel you to avoid diving and swimming and to avoid blowing your nose as much as possible. You should also avoid any non-essential medications. For rips along the edges of the eardrum, the specialist may choose to put in a temporary dam or patch which helps prevent infection. In rare cases, surgery may be recommended.

Your specialist may also order over-the-counter (OTC) pain medications such as aspirin or acetaminophen to cope with any discomfort. The key precautions you can take to prevent this condition are to 1) avoid putting any foreign objects into your ears, even for cleaning, and 2) deal with ear infections without delay by visiting a hearing healthcare provider.