What Causes a Ruptured Ear Drum?

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What Causes a Ruptured Ear Drum?

A ruptured ear drum is also called a perforated ear drum by medical professionals. To truly understand what causes this condition you must understand the function of the ear drum (also called the tympanic membrane) and some of the physiology and anatomy of the inner ear.

The ear drum is a thin membrane that separates the ear canal from the middle ear. The auditory tube (also called the Eustachian tube), is a small tube that runs from the middle ear to the nose.

The auditory tube functions to clear mucous from the inner ear, ventilate the middle ear and to equalize atmospheric pressure within the middle ear. It does this in part by opening and closing at strategic times to allow ventilation of the middle ear. When the auditory tube fails to function properly (a condition called auditory tube dysfunction) pressure can build inside of the middle ear causing the ear drum to bulge or even rupture, (this means that the thin membrane actually breaks or gets a hole in it). Many conditions can cause the auditory tube to dysfunction including excess mucous (congestion) from a cold or allergies, which may clog the auditory tube or prevent it from opening properly or enlarged structures such as the adenoids which may crowd or block the auditory tube. The following conditions can also cause a ruptured ear drum:

  • ear infections
  • rapid changes in ambient pressure (called barotrauma - often occurs while scuba diving, taking off or landing in an airplane)
  • extremely loud noises such as a gun shot or explosion
  • foreign objects like pencils or bobby pins inserted into the ear which can puncture the eardrum
  • trauma (if the ear is struck or in the case of a skull fracture for example)

These conditions are usually accompanied by an underlying cause of auditory tube dysfunction.

Children may be at higher risk of rupturing their ear drum than adults since the auditory tube in children is smaller and does not function as efficiently as it does in adults. That being said, a ruptured ear drum can occur in individuals of all ages. Some people suffer from chronic auditory tube dysfunction and this condition can actually weaken the ear drum over time. For example, someone who has chronic auditory tube dysfunction from untreated allergies may be more likely to rupture their ear drum while taking off in an airplane than someone who has a normally functioning auditory tube.

Symptoms of a Ruptured Ear Drum

Ruptured ear drums can be painful at the time of rupture and are sometimes followed by a feeling of relief if the rupture is due to high pressure. Symptoms of a ruptured ear drum can include:

Diagnosing a Ruptured Ear Drum

Diagnosing a ruptured ear drum is not usually difficult. Your doctor will ask you about your symptoms and the circumstances surrounding the rupture. Then the doctor will examine your ear drum with an instrument called an otoscope. If the ear drum has ruptured damage to the tympanic membrane such as a hole, a scab, or a scar may be visible.

 

How is a Ruptured Ear Drum Treated?

The treatment of a ruptured ear drum is not usually complicated. In most cases, the ear drum will heal on its own in a matter of days. You should see a doctor if you suspect an ear infection, or if persistent ear drainage  or hearing loss is involved. A doctor may prescribe antibiotics. Over-the-counter pain relievers like acetaminophen are often helpful for pain.

In some rare cases, it may be necessary for a doctor to surgically repair the perforation (hole). This usually involves placing a patch over the damaged part of the ear and can sometimes even be done in the physician's office.

You should probably keep water out of your ear until the perforation has healed to avoid infection.

If your ruptured ear drum was caused by underlying auditory tube dysfunction this should also be treated. You may need to be tested for allergies or have sinus problems treated. These issues are usually best addressed by a doctor who specializes in disorders of the ear, nose and throat.

Source:

American Academy of Otolaryngology - Head and Neck Surgery. Perforated Eardrum. Accessed: February 23, 2016 from http://www.entnet.org/content/perforated-eardrum

Medscape. Eustachian Tube Function. Accessed: February 23, 2016 from http://emedicine.medscape.com/article/874348-overview

Medline Plus. Ruptured Eardrum. Accessed: July 21, 2010 from

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