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Symptoms and Signs of Perforated Eardrum
(Ruputured Eardrum)

Doctor's Notes on Perforated Eardrum
(Ruputured Eardrum)

Perforated or ruptured eardrum is a hole or tear in the tympanic membrane, also known as the eardrum. The most common sign and symptom of a perforated eardrum is an earache or pain; the pain can be a general discomfort of the ear and/or immediate, sharp or intense pain that occasionally suddenly gets better. Other common symptoms and signs include a vague feeling that there’s something wrong with the ear, vertigo, dizziness, hearing changes, ringing in the ear (tinnitus), hearing loss and clear or pus-colored fluid draining from the ear that may contain blood.

The most common cause of the eardrum perforation is a middle ear infection. Middle ear infections can be caused by viruses, bacteria or fungi that increase the pressure behind your tympanic membrane, often stretching it until it breaks or tears. The sudden release of pressure (for example, the tear) reduces the pressure and usually decreases the pain. Blunt or penetrating trauma such as a fall or a foreign object that goes deep in your ear can also perforate the eardrum. Rapid pressure changes also cause eardrum perforation. There are many examples; scuba diving barotrauma, slaps to the ear while falling during waterskiing, blast waves from gunshots, fireworks or other blasts, changes in air pressure during air travel, and sports injuries that involve blows to the ears.

Medical Author:
Medically Reviewed on 3/11/2019

Perforated Eardrum
(Ruputured Eardrum) Symptoms

Earache is the most common symptom of a perforated eardrum. The pain can include:

  • General discomfort
  • Immediate, sharp, or intense pain
  • Pain that suddenly gets better
  • A feeling as if something is not right with the ear

Other common symptoms and signs of perforated eardrum include:

  • Vertigo (spinning sensation)
  • Dizziness
  • Hearing changes
    • Often with ringing (tinnitus), buzzing, clicking, or other noise
  • Hearing loss
  • Fluid (may be clear or pus-colored) or blood draining from the ear

Perforated Eardrum
(Ruputured Eardrum) Causes

Middle ear infection is the most common cause of a ruptured eardrum.

  • Ear infections can be caused by viruses, bacteria, or fungi.
  • Middle ear infections increase the pressure behind your eardrum, stretching the drum and causing pain.
  • When the eardrum can no longer stretch, it bursts or tears.
  • Frequently, the earache gets better, because the pressure is now relieved, however, sometimes the pain can get worse.

Trauma can also cause perforation.

  • Blunt or penetrating trauma, such as from a fall on the side of your head or a stick that goes deep in your ear
  • Rapid pressure changes, for example, scuba diving (barotrauma, ear pain, or ear squeeze)
  • Slaps to the ear, such as a fall while water skiing or a hand slap to the side of the head
  • Lightning blasts
  • Blast waves from gunshots, fireworks, and other loud noises or explosions
  • Changes in air pressure during air travel or scuba diving
  • Sharp objects or cotton swabs
  • Motor vehicle accidents
  • Falls
  • Sports injuries

Ear Infection Symptoms, Causes, and Treatment Slideshow

Ear Infection Symptoms, Causes, and Treatment Slideshow

Sometimes it seems like kids are always getting ear infections. Ear infections are very common in children. Children get ear infections about two out of every three times they have a cold. Children are more prone to ear infections because their small ears do not drain fluid as well as adult ears. Kids’ immune systems are also immature, and this increases the likelihood of certain infections.

There are three types of ear infections. Each type is defined according to where they occur in the ear canal. An ear infection may take place in the inner, middle, or outer ear. Each type of ear infection may exhibit different symptoms.


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.