Ruptured Eardrum - Symptoms, causes and treatment

A ruptured eardrum is a condition when there is a hole or tear in the tympanic membrane (ear drum) layer in the middle of the channel ear. This condition is usually a symptom or complication of another disease, such as an ear infection.

The tympanic membrane functions to transmit sound waves from the outer ear. These sound waves are received by the tympanic membrane in the form of vibrations and transmitted to the middle and inner ear.

In the inner ear, these vibrations are converted into signals. After that, the signal will be sent to the brain to be translated into sound. Therefore, if the tympanic membrane is damaged or ruptured, hearing can be impaired.

A ruptured eardrum can heal on its own in a few weeks or months. However, in some cases, this condition requires medical treatment in the form of ear fillings or surgery.

Causes of Ruptured Eardrum

A ruptured eardrum can be caused by several conditions, including:

  • Infection

    Ear infections are a common cause of ruptured eardrums. Ear infections, such as otitis media, cause a buildup of fluid in the middle ear. This buildup of fluid causes pressure that can tear the eardrum.

  • Pressure

    A drastic difference in pressure between the outer and middle ear, such as when diving, flying in an airplane, driving to high altitudes, or climbing a mountain, can cause the eardrum to tear. This condition is known as barotrauma.

  • Injury

    A ruptured eardrum can also be caused by an injury to the ear or the side of the head. In addition, direct injuries from inserting objects into the ear canal, such as cotton bud or earplugs, can also cause the eardrum to burst.

  • Loud noise

    Very loud noises or explosive sounds, such as gunshots, can cause the eardrum to burst. This condition is called acoustic trauma. However, cases like this are rare.

Risk factors for ruptured eardrum

A ruptured eardrum can happen to anyone. However, there are a number of factors that can increase a person's risk of developing the condition, namely:

  • Have an ear infection, such as otitis media or otitis externa
  • Have a history of ruptured eardrum or previous ear surgery
  • Doing activities that can cause pressure changes, such as diving, mountain climbing, or boarding an airplane
  • Having an ear injury due to an accident while driving or playing sports
  • Inserting a foreign object into the ear, such as when using cotton buds

Symptoms of a Ruptured Eardrum

The main symptom that appears when the eardrum ruptures is severe pain in the ear that occurs suddenly. The pain will usually get worse and subside within a few minutes, but it can also last longer.

In addition to complaints of ear pain, sufferers of a ruptured eardrum can experience different accompanying symptoms. These symptoms include:

  • Hearing disorders
  • Fever
  • Itchy ears
  • Tinnitus or ringing in the ears
  • Discharge of fluid in the form of pus that can be mixed with blood from the ear canal
  • Dizziness or vertigo
  • Nausea and vomiting due to vertigo
  • Weakness of facial muscles

When to go to the doctor

Check with your doctor if you experience the symptoms and complaints mentioned above or have an ear injury. The eardrum has a thin and delicate structure that makes it vulnerable to damage if the ear is injured or has certain diseases.

Go to the emergency room immediately if you experience severe symptoms, such as discharge from the ear, severe pain in the ear, sudden deafness, or dizziness that causes nausea and vomiting.

Ruptured Eardrum Diagnosis

To diagnose a ruptured eardrum, the doctor will ask the patient's symptoms and complaints, past medical history, and the patient's habits in cleaning the ears.

After that, the doctor will look at the condition of the eardrum using an ear speculum or otoscope. If the results of the examination show that the patient has a ruptured eardrum, the doctor will refer the patient to an ear, nose and throat (ENT) specialist for further examination.

The ENT doctor will perform several tests to find out the cause of the ruptured eardrum or to check for hearing loss. Tests that may be performed include:

  • Culture test on discharge from the ear (if any), to determine the type of bacteria causing the ear infection
  • Audiometry or tuning fork test, to check hearing sensitivity to several sounds with different pitches and volumes
  • Tympanometry, to check the response of the eardrum to changes in pressure using a special instrument called a tympanometer

Ruptured Eardrum Treatment

Generally, a ruptured eardrum will heal on its own in 6–8 weeks. However, if there are signs of infection or a ruptured eardrum does not heal on its own, then medical treatment is required.

Some of the treatments that can be done to treat a ruptured eardrum are:

Medical treatment

Medical treatment of the eardrum aims to relieve pain and treat or prevent infection. Medical actions taken by doctors include:

  • Drug administration-medicine

    The doctor will give antibiotics in the form of drops or oral medication to prevent or treat ear infections. Your doctor will also give you pain relievers, such as ibuprofen or paracetamol, if the pain from a ruptured eardrum doesn't go away.

  • Patching tear or hole

    If the tear or hole in the eardrum doesn't heal on its own, the doctor will apply a chemical to the edge of the tear and apply special paper as a patch. This filling will stimulate the healing process of the eardrum until it is fully closed.

  • Surgery or surgery

    If the filling of the tear or hole in the eardrum is unsuccessful, the doctor will perform eardrum surgery or tympanoplasty. This surgery is done by grafting other tissue to the ruptured eardrum.

Self care at home

To help the healing process of a ruptured eardrum, patients can also perform self-care at home. Treatments that can be done include:

  • Keep the ears dry by using earplugs or special tools to prevent water from entering when bathing
  • Avoiding risky activities, such as swimming, traveling to high altitudes, and doing strenuous exercise
  • Do not hold your breath in your nose when you sneeze because it can increase the pressure in your ears and make the condition worse
  • Resist the urge to clean the ear for a while until the ruptured eardrum heals
  • Compress the ear with a warm dry towel

Complications of Ruptured Eardrum

As mentioned above, the eardrum plays an important role in the hearing process. In addition, the eardrum also serves to protect the middle ear from bacteria or water trying to enter.

If there is damage to the eardrum, it is possible for the patient to experience the following complications:

  • Chronic otitis media or long term middle ear infection
  • Cholesteatoma or cyst in the middle ear that can damage the bone structure of the ear
  • Deaf or hearing loss

Prevention of Ruptured Eardrum

There are several things you can do to prevent the eardrum from bursting. The following are things you can do to protect the eardrum:

  • Do not use hard or sharp objects to clean the ears.
  • As much as possible avoid traveling by plane when you have a cold or sinusitis.
  • Use earplugs, chew gum, or yawn when there is a change in ear pressure, so that the pressure inside the ear remains stable.
  • Use personal protective equipment in the form of earplugs, when working in a noisy environment.