What Causes a Ruptured Ear Drum?

Eardrum. Photo © A.D.A.M.

Question: What Causes a Ruptured Ear Drum?


A ruptured ear drum is also called a perforated ear drum. 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. 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)
  • loud noises
  • 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.

Ruptured eardrums 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 fluid draining from the ear, ear pain, sudden hearing loss tinnitus (ear ringing), or dizziness.

The treatment of a ruptured ear drum is not usually complicated. In most cases, the ear drum will heal on its own. In some cases, it may be necessary for a doctor to 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.

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 very severe (rare) cases the eardrum may have to be surgically repaired.


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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