Symptoms and Signs of Perforated Eardrum (Ruputured Eardrum)

Medical Author:
Medically Reviewed on 8/19/2021

Doctor's Notes on Perforated Eardrum
(Ruputured Eardrum)

A 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. Causes include 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.

What Are the Treatments for a Perforated Eardrum (Ruptured Eardrum)?

The treatment of a perforated eardrum varies with the severity of the injury. Small holes often heal without treatment. Some larger holes may require a patch. Large tears may need to be surgically repaired by an ENT specialist. Have your ears checked within 24 hours if you suspect an eardrum rupture, even if it is small. Seek immediate care if you experience any of the following:

  • You have severe symptoms such as pain, bleeding, and/or ringing in your ear.
  • You have sudden loss of hearing.
  • You develop dizziness.
  • You have something lodged in your ear.

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