Ruptured eardrum (perforated eardrum)

Your provider or an ENT specialist can often determine if you have a ruptured (perforated) eardrum with a visual inspection using a lighted instrument (otoscope or microscope).

Your provider may conduct or order additional tests to determine the cause of your ear symptoms or to detect the presence of any hearing loss. These tests include:

• Laboratory tests. If there's discharge from the ear, your provider may order a laboratory test or culture to detect a bacterial infection of the middle ear.

• Tuning fork evaluation. Tuning forks are two-pronged, metal instruments that produce sounds when struck. Simple tests with tuning forks can help your provider detect hearing loss.

  A tuning fork evaluation may also reveal whether hearing loss is caused by damage to the vibrating parts of the middle ear (including the eardrum), damage to sensors or nerves of the inner ear, or damage to both.

• Tympanometry. A tympanometer uses a device inserted into the ear canal that measures the response of the eardrum to slight changes in air pressure. Certain patterns of response can indicate a perforated eardrum.
• Audiology exam. This is a series of tests that measure how well you hear sounds at different volumes and pitches. The tests are conducted in a soundproof booth.

Most ruptured (perforated) eardrums heal without treatment within a few weeks. Your provider may prescribe antibiotic drops if there's evidence of infection. If the tear or hole in the eardrum doesn't heal by itself, treatment will likely involve procedures to close the tear or hole. These may include:

• Eardrum patch. If the tear or hole in the eardrum doesn't close on its own, an ENT specialist may seal it with a paper patch (or a patch made of other material).

  With this office procedure, your ENT doctor may apply a chemical to the edges of the tear, which can promote ear drum healing, and then apply a patch over the hole. The procedure may need to be repeated more than once before the hole closes.

• Surgery. If a patch doesn't result in proper healing or your ENT doctor determines that the tear isn't likely to heal with a patch, he or she may recommend surgery.

  The most common surgical procedure is called tympanoplasty. Your surgeon grafts a patch of your own tissue to close the hole in the eardrum. This procedure is done on an outpatient basis. In an outpatient procedure, you can usually go home the same day unless medical anesthesia conditions require a longer hospital stay.

A ruptured (perforated) eardrum usually heals on its own within weeks. In some cases, healing takes months. Until your provider tells you that your ear is healed, protect it by:

• Keeping the ear dry. Place a waterproof silicone earplug or cotton ball coated with petroleum jelly in the ear when showering or bathing.
• Refraining from cleaning the ears. Give the eardrum time to heal completely.
• Avoiding blowing your nose. The pressure created when blowing your nose can damage the healing eardrum.

If you have signs or symptoms of a perforated eardrum, you're likely to start by seeing your provider. However, your provider may refer you to a specialist in ear, nose and throat (ENT) disorders (otolaryngologist).

Here's some information to help you prepare for your appointment.

What you can do

Make a list ahead of time that you can share with your provider. Your list should include:

• Symptoms you're experiencing, including any that may seem unrelated to hearing loss, fluid discharge or other ear-related symptoms
• Relevant events that may be related to your ear problems, such as a history of ear infections, recent ear injuries or head traumas, or recent air travel
• Medications, including any vitamins or supplements you're taking
• Questions for your provider

If you think you have signs or symptoms of a ruptured eardrum, you may want to ask your provider some of the following questions.

• Do I have a ruptured eardrum?
• What else could be causing my hearing loss and other symptoms?
• If I have a ruptured eardrum, what do I need to do to protect my ear during the healing process?
• What type of follow-up appointments will I need?
• At what point do we need to consider other treatments?

Don't hesitate to ask other questions you have.

What to expect from your doctor

Your provider is likely to ask you a number of questions, including:

• When did you first experience symptoms?
• Did you have symptoms such as pain or vertigo that cleared up?
• Have you had ear infections?
• Have you been exposed to loud sounds?
• Have you been swimming or diving recently?
• Have you recently flown?
• Have you had head injuries?
• Do you put anything in your ear to clean it?

What you can do in the meantime

If you think that you have a ruptured eardrum, be careful to keep your ears dry to prevent infection.

Don't go swimming until your condition has been evaluated and discussed with your provider. To keep water out of the ear when showering or bathing, use a moldable, waterproof silicone earplug or put a cotton ball coated with petroleum jelly in the outer ear.

Don't put medication drops in the ear unless your provider prescribes them specifically for infection related to the perforated eardrum.