BASIC INFORMATION

DESCRIPTION
A perforation of the thin membrane (tympanic membrane) that separates the inner ear from the outer ear.

FREQUENT SIGNS AND SYMPTOMS
Sudden pain in the ear. Partial hearing loss. Bleeding or discharge from the ear. The discharge may resemble pus within 24 to 48 hours after rupture. Ringing in the ear. Dizziness.

CAUSES
Perforation of the eardrum when a sharp object is inserted in the ear, such as a cotton swab or paper clip to clean the ear or relieve an itch; an unseen twig on a tree. Sudden inward pressure in the ear, such as with a slap, a swimming or diving accident, a nearby explosion. Sudden outward pressure or suction, such as with a kiss over the ear. Severe middle-ear infection.

RISK INCREASES WITH:
Recent middle-ear infection. Head injury.

PREVENTIVE MEASURES
Don't put any object into the ear canal. Avoid injuries that may cause a rupture (see Causes). Obtain prompt medical treatment for middle-ear infections.

EXPECTED OUTCOME
If the ruptured eardrum does not become infected, it will usually repair itself in 2 months. If it becomes infected, the infection is curable with treatment, and hearing is usually not affected permanently. If the perforation does not heal, surgery is needed.

POSSIBLE COMPLICATIONS
Ear infection, with fever, vomiting and diarrhea.  Significant blood loss (rare). Meningitis. Mastoiditis (infection of the mastoid [bony area just behind the ear]). Permanent hearing loss (rare).

TREATMENT

GENERAL MEASURES
Diagnosis is verified by otoscope examination of the ear. A culture of the fluid from the ear may be done also. Treatment involves medication to prevent infection and supportive care for pain. Don't blow your nose, if possible. If you must, blow gently. Keep the ear canal dry. Don't swim, take showers or caught in the rain. Microsurgery to repair the perforation if it doesn't heal spontaneously.

MEDICATION
Antibiotics to prevent or treat infections. Pain relievers. For minor pain, you may use non-prescription drugs such as acetaminophen.

ACTIVITY
Resume your normal activities as soon as symptoms improve.

DIET
No special diet.

NOTIFY OUR OFFICE IF
You or a family member has symptoms of a ruptured eardrum, especially pus-like discharge. The following occur during treatment: Fever. Pain that persists, despite treatment.  Dizziness that continues longer than 12 to 24 hours. New, unexplained symptoms develop. Drugs used in treatment may produce side effects.