Diagnosis

Your family doctor or ENT specialist can often determine if you have a perforated eardrum with a visual inspection using a lighted instrument (otoscope).

He or she may conduct or order additional tests to determine the cause of the rupture or degree of damage. These tests include:

  • Laboratory tests. If there's discharge from your ear, your doctor may order a laboratory test or culture to detect a bacterial infection of your 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 doctor detect hearing loss. A tuning fork evaluation may also reveal whether hearing loss is caused by damage to the vibrating parts of your middle ear (including your eardrum), damage to sensors or nerves of your inner ear, or damage to both.
  • Tympanometry. A tympanometer uses a device inserted into your ear canal that measures the response of your eardrum to slight changes in air pressure. Certain patterns of response can indicate a perforated eardrum.
  • Audiology exam. If other hearing tests are inconclusive, your doctor may order a series of strictly calibrated tests conducted in a soundproof booth that measure how well you hear sounds at different volumes and pitches (audiology exam).

Treatment

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

  • Eardrum patch. If the tear or hole in your eardrum doesn't close on its own, an ENT specialist may seal it with a patch. With this office procedure, your ENT doctor may apply a chemical to the edges of the tear to stimulate growth 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 tiny patch of your own tissue to close the hole in the eardrum. This procedure is done on an outpatient basis, meaning you can usually go home the same day unless medical anesthesia conditions require a longer hospital stay.

Lifestyle and home remedies

A ruptured eardrum usually heals on its own within weeks. In some cases, healing takes months. Until your doctor tells you that your ear is healed, protect it by doing the following:

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

Preparing for your appointment

If you have signs or symptoms of a perforated eardrum, you're likely to start by seeing your family doctor or general practitioner. However, your doctor may refer you to a specialist in ear, nose and throat (ENT) disorders (ENT physician, or 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 doctor. 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 injuries or recent air travel
  • Medications, including any vitamins or supplements you're taking
  • Questions for your doctor

If you think you have signs or symptoms of a ruptured eardrum, you may want to ask your doctor 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 doctor 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. To keep water out of your ear when showering or bathing, use a moldable, waterproof silicone earplug or put a cotton ball coated with petroleum jelly in your outer ear.

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

Nov. 10, 2016
References
  1. Perforated eardrum. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/content/perforated-eardrum. Accessed Sept. 19, 2016.
  2. Evans AK, et al. Evaluation and management of middle ear trauma. http://www.uptodate.com/home. Accessed Sept. 19, 2016.
  3. Lalwani AK. Temporal bone trauma. In: Current Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com. Accessed Sept. 19, 2016.
  4. Vernick DM. Ear barotrauma. http://www.uptodate.com/home. Accessed Sept. 19, 2016.
  5. Traumatic perforation of the tympanic membrane. Merck Manual Professional Version. https://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/middle-ear-and-tympanic-membrane-disorders/traumatic-perforation-of-the-tympanic-membrane. Accessed Sept. 20, 2016.

Ruptured eardrum (perforated eardrum)