What exactly is a ruptured eardrum?

Maybe you had a bad ear infection recently. Or you traveled on a plane with a cold. Or you tried scuba diving on vacation. What do all these scenarios have in common? They may cause a ruptured eardrum, which is painful and could harm your hearing.

Here’s what to know and how to keep your eardrums safe.

What is a ruptured eardrum?

A ruptured eardrum is a hole or tear in that part of your ear, says Viral Tejani, Au.D., Ph.D. He’s an assistant professor of otolaryngology–head and neck surgery at Case Western Reserve University School of Medicine in Cleveland. “The eardrum separates your outer ear, or ear canal, from your middle ear, where the 3 middle ear bones are,” he explains.

The eardrum has several functions. It helps you hear by vibrating when sounds travel from the outer ear. Those vibrations turn into signals that go to the brain.¹ The brain then translates them into the sounds you hear. The eardrum also protects your middle ear from bacteria, water and dust.¹

Ruptured eardrums are not uncommon – about 2% of the population currently has one.² “They tend to occur more frequently in children, compared to older adults,” notes Anish Thakkar, Au.D. He’s an audiologist at the Los Angeles Center for Ear, Nose, Throat and Allergy in Los Angeles.

Picture a hole in a snare or bass drum. That’s what essentially happens with a ruptured eardrum. When it has a hole, sound can’t move as effectively through your middle ear bones, Thakkar explains. The result: hearing loss.

The medical term for a ruptured eardrum is tympanic membrane (TM).¹ If you are diagnosed with one, that’s what you may see in your medical chart.

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What causes a ruptured eardrum?

The most common cause is a middle ear infection, says Thakkar. If you have one, fluids may build up in your ear, which presses on your eardrum and could cause it to burst. Other causes include:³

• A physical injury to your head or ear. This could range from an overzealous cotton swab to a blow on the side of your head, notes Thakkar.
• Loud noises close to your ear, such as an explosion or gunshot.
• Rapid changes in air pressure. This can happen if you’re flying on a plane, scuba diving or going up into the mountains.

A ruptured eardrum may happen to anyone. But it’s more likely if you already have fluid in your ears. This could cause eustachian tube dysfunction (ETD). ETD prevents your middle ear space from equalizing pressure with the outside world, explains Thakkar.

What does a ruptured eardrum feel like?

If your ear hurts, like the pain from an ear infection, you may find that it feels better once your eardrum bursts.³ But once that happens, you might notice:^{1, 4}

• Ear pain, especially sharp pain
• Fluid or pus leaking out of your ear
• Buzzing or ringing in your ear
• Trouble hearing or muffled hearing in your ear
• Dizziness or vertigo

How is a ruptured eardrum treated?

If you think that you have a ruptured eardrum, see an ear, nose and throat doctor (ENT). They can look into your ear with a lighted device called an otoscope. If there’s just a small hole, they may recommend initially that you watch and wait. “TM perforations can heal on their own in many cases, if they’re small,” says Tejani.

As you wait, there are some simple things you can do at home to ease pain and speed up recovery. They include:³

• Place warm compresses on your ear
• Try over-the-counter pain relievers such as ibuprofen or acetaminophen
• Avoid swimming

Your ENT may also prescribe antibiotic eardrops to prevent infection.

If your eardrum heals on its own, your hearing should return to normal. If it doesn’t, an ENT may recommend one of these medical procedures:¹

• Myringoplasty. If the hole is small, an ENT repairs it by placing gel or a special paper over the eardrum. The eardrum tissue grows back, filling in the hole.
• Tympanoplasty. “The goal is to reconstruct and thus restore the eardrum,” says Thakkar. An ENT will take skin or cartilage from another part of your body to use as a patch over the hole or tear.

Can you prevent a ruptured eardrum?

There are some steps that may help lower the odds of a ruptured eardrum:^{1, 4, 5}

• Treat ear infections as soon as you can.
• Never put cotton swabs or other objects into your ears, says Tejani.
• Yawn or chew gum when you fly on a plane. “This will help to counteract pressure changes,” explains Tejani.
• Wear earplugs if you know that you’ll be around loud noises. Thakkar recommends investing in custom-made hearing protection. “They tend to be form-fitted to the ear, and thus protect the ears more securely than over-the-counter alternatives,” he says.
• Don’t swim in lakes, especially without special swimming earplugs, advises Thakkar. Lakes can harbor bacteria that could trigger ear infections.
• Sneeze with your mouth open. This helps take pressure off your middle ear canal. But don’t forget to cover your mouth with your arm or tissue so you don’t spread germs.
• Don’t blow your nose too hard.

The good news: Hearing loss from a ruptured eardrum is often temporary.⁴ Usually, patients can regain hearing after they recover, notes Thakkar. But your hearing may not be exactly as it was before, he adds. If that’s the case, it’s a good idea to talk to your ENT or primary care provider. They may recommend further treatment.

Take care of your hearing: Did you know that many hearing benefits, including a hearing exam and consultation, are covered through EPIC Hearing Healthcare? Learn more.

Sources

1. Ruptured eardrum (acutely perforated tympanic membrane) Cleveland Clinic. Last reviewed November 21, 2022.
2. Prevalence of tympanic membrane perforations among adolescents, adults, and older adults in the United States Otolaryngology–Head and Neck Surgery. August 2022.
3. Ruptured eardrum National Library of Medicine: MedlinePlus. Last reviewed May 30, 2022.
4. Ruptured eardrum (perforated eardrum) Mayo Clinic. January 18, 2022.
5. Swimmer’s ear Mayo Clinic. August 13, 2021.

Information is for educational purposes only and is not a substitute for the advice of a licensed medical provider. Consult your provider prior to making changes to your lifestyle or health care routine.

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