The tympanic membrane, more commonly known as the eardrum, is a thin layer of tissue that separates your outer ear from the middle ear. Although fairly uncommon, a ruptured or perforated eardrum can occur. The good news is that in most cases a ruptured eardrum will heal within a few weeks without any treatment.

The main functions of the eardrum are to aid in hearing and to act as a barrier for such things as water and other foreign substances from entering the middle ear.

A common cause of a ruptured or perforated eardrum is a middle ear infection. The infection results in an accumulation of fluid in the middle ear, which increases the pressure on the inside of the eardrum. If this pressure is substantial enough, it may cause the eardrum to rupture.

Another cause of a ruptured eardrum is barotrauma. Barotrauma is caused by unequal pressure on either side of the eardrum.

A common example of barotrauma is associated with air travel. As a result, barotrauma is commonly referred to as airplane ear. Barotrauma can also occur when scuba diving or when direct trauma occurs to the ear. Injury to the eardrum caused by loud noises or blasts is referred to as acoustic trauma. Examples of this include explosions or gunshots. In these cases, the large sound wave essentially tears the eardrum. Lastly, foreign objects such as cotton swabs may also cause injury to the eardrum.

The signs and symptoms associated with an eardrum rupture will vary from person to person. However, a common symptom is severe, constant ear pain that stops suddenly. In the case of an ear infection, a clear or bloody discharge may leak from the ear. Often, varying degrees of hearing loss and/or ringing in the ear is noticed. In severe cases vertigo, nausea or vomiting may also be present.

It is important to seek medical attention if you experience any of the above symptoms. Your doctor can often diagnose a perforated eardrum by taking a detailed history and performing a physical examination. During this examination, your doctor will inspect your ear using an otoscope. If your doctor feels it is necessary, he or she may order other diagnostic testing to determine the root cause as well as the severity of the rupture.

As stated earlier, most perforated eardrums heal without medical intervention. However, if the eardrum does not heal on its own, medical treatment may be necessary. The overall goal of treatment is to close or seal the ruptured eardrum. Treatments may include an eardrum patch, which is essentially a paper patch placed over the hole, or in severe cases surgery may be required. A surgery called a tympanoplasty – in which a surgeon grafts a small patch of your own tissue over the ruptured eardrum – is usually performed on an outpatient basis.

If you have a ruptured eardrum, there are a few things you can do at home to help it heal. First of all, try to keep the eardrum dry by using waterproof earplugs or a cotton ball coated with petroleum jelly during showers. Avoid placing foreign objects such as cotton swabs in the ear until the eardrum has healed fully. Lastly, refrain from blowing your nose as the pressure caused by this action may cause re-injury. Preventing a ruptured eardrum is not always possible. However, taking precautions such as wearing protective earplugs during work or recreational activities that expose you to loud sounds is always a good idea. Avoiding airplane flights when you have a cold may also reduce the risk of a ruptured eardrum. Until next month, drive safely.