Ruptured / Perforated eardrum

A ruptured eardrum is a hole or tear in the thin tissue that separates the ear canal from the middle ear.

A ruptured eardrum can result in hearing loss. It can also make the middle ear vulnerable to infections. A ruptured eardrum usually heals within a few weeks without treatment. But it sometimes it requires or surgical repair to heal.

Signs and symptoms of a ruptured eardrum may include:

● Ear pain that may subside quickly
● Mucus-like, pus-filled or bloody drainage from the ear
● Hearing loss
● Ringing in the ear (tinnitus)
● Spinning sensation (vertigo)
● Nausea or vomiting that can result from vertigo

Causes

There are many causes of a ruptured (perforated) eardrum. Some of them include:

● Middle ear infection (otitis media)
● Barotrauma. Barotrauma is stress exerted on the eardrum when the air pressure in the middle ear and the air pressure in the environment are out of balance
● Loud sounds or blasts
● Foreign objects in your ear
● Severe head trauma

Complications

The eardrum (tympanic membrane) has two primary roles:

● Hearing
● Protection

If the eardrum ruptures, uncommon problems can occur, especially if it fails to self-heal. Common complications include:

● Hearing loss
● Middle ear infection (otitis media)
● Middle ear cyst (cholesteatoma)
● Mastoiditis (infection to temporal bone)

Evaluation

Investigations will include

● Physical examination
● Endoscopic evaluation
● Audiometric evaluation
● Imaging – HRCT temporal bones

Treatmentx`

Tympanic membrane may self heal if not associated with any persistant infection.

If eardrum doesn’t heal, surgical treatment might be advised – tympanoplasty , mastoidectomy with or without oscciculoplasty depending on nature and extent of infection spread.