Perforated Eardrum (Burst Eardrum)

Perforated Ear Drum

Agents that may cause a burst eardrum are:

A Middle ear infection (otitis media). This infection is usually caused by bacterial growth in the middle ear cavity. The resultant body's inflammation response can block off the Eustachian tube (normally drains the middle ear and keeps pressure in the middle ear cavity the same as the outside ). When the Eustachian tube is blocked, there is no way for the bacterial wastes to go and a puss-like fluid grows inside the chamber and puts pressure on the eardrum, causing severe pain. In fact if you could see the outside of an eardrum with this condition, it would appear to have a big bulge towards the outside. If the Eustachian tube does not open under the pressure, the eardrum is pushed outward until the tympanic (ear drum) membrane literally rips apart. The pain is immediately relieved and usually a nasty smelling concoction comes pouring out. This is good condition and edges of the hole will usually heal together over a few weeks. In some cases, however, if the hole remains open due to the rupture, it would be easy to for other opportunistic infections to enter the middle ear and cause more pain and damage. If you have not seen a doctor before or after the rupture, do so, so he/she can give you antibiotic ear drops to minimize any future infections while the tear heals.

If the eardrum does not heal on its own, surgical repair (tympanoplasty) may be necessary to close the tear in the ear drum.

Damaged from a foreign object or sudden noise.
- Pushing cotton-tipped swabs too far into the ear canal
- Extremely loud noise like an explosion (greater that 190DB)
- A hard bang to the head or trauma that causes a fracture of the skull
- Hitting the ear with an open hand (this is very rare as the open hand would have to seal the ear canal at the exact moment it hits the side of the head causing a strong pressure wave to be channeled into the ear canal)

Other causes that might perforate the eardrum are:

Sudden change of air pressure during diving into water, especially if you dive having a head cold or sinusitis
Sudden change of air pressure during air travel (very rare - usually is caused by fast descents when having a head cold or sinusitis))
Middle ear tumor or built-up residue such as a cholesteatoma, which puts pressure against the inner ear drum (also very rare)

Treatment for Burst Eardrum

From Internal Causes:

Let the eardrum heal on its own for about 7-10 days. If you are concerned during this time go to your family physician and get antibiotics (drops and perhaps a shot with a regimen of antibiotic pills). For the first three days you may also get drainage of a smelly pus. This is a good sign that the body is ejecting the infectious material as it heals. Just wipe it off the outer ear with a damp cloth.

If the eardrum does not appear to be healed after 10 days, or the pus continues to drain after 4 days, it may mean that the infection in the middle ear is stubborn and more aggressive treatment is needed. See your family physician who may also refer you to an ENT (Ear, Nose, Throat) specialist for specialist treatment.

From External Causes:

Any type of burst eardrum event from external sources requires an immediate trip to the Emergency Room. After stabilizing, the ER doctors will always refer you to an ENT specialist on their staff or refer you to one outside their facility. Depending on the severity of the incident, you may or may not require surgery.

DO NOT DELAY IN GETTING MEDICAL HELP!

During Healing

Keep the ear canal clean, dry, and free of anything while the eardrum heals. Insert ear plugs gently into the ears when showering or shampooing to block any water from getting in - don't use cotton balls as they absorb moisture. If pain continues during the healing process, lie down with the other side of the head on a pillow and apply a warm compress to the affected ear for about 15 minutes. Heat packs available at any drugstore are good for this procedure. Don't worry about drainage for the first 3 days. Just wipe it off the outer ear with a damp cloth.