Perforated eardrum
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Tympanic membrane perforation; eardrum – ruptured or perforated
Overview
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Rupture or perforation (hole) of the eardrum can occur in infection, trauma (e.g. by trying to clean the ear with sharp instruments), explosion or loud noise. Flying with a severe cold can also cause perforation due to changes in air pressure and blocked eustachian tubes resulting from the cold. This is especially true on landing.
Perforation of the eardrum leads to conductive hearing loss.
The perforation may heal in a few weeks, or up to a few months. Some perforations require intervention – this may use a paper patch to promote healing (simple procedure in the office of an ear, nose and throat specialist), or surgery (tympanoplasty).
Hearing is usually recovered fully, but chronic infection over a long period may lead to permanent hearing loss.
Treatment
Surgery
Surgical repair of the eardrum tympanoplasty may be needed if the eardrum does not heal on its own.
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Historical Perspective
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Pathophysiology
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Causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Causes
Ear infections may cause a ruptured eardrum, more often in children. The infection causes pus or fluid to build up behind the eardrum. As the pressure increases, the eardrum may break open (rupture).
Damage to the eardrum can also occur from:
- A very loud noise close to the ear, such as a gunshot.
- A rapid change in ear pressure, which may occur when flying, scuba diving, or driving in the mountains.
- Foreign objects in the ear.
- Injury to the ear (such as a powerful slap or explosion).
- Inserting cotton-tipped swabs or small objects into the ear to clean them.
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Differentiating Perforated Eardrum from other Diseases
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Epidemiology and Demographics
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Risk Factors
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Natural History, Complications and Prognosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Prognosis
The opening in the eardrum usually heals by itself within 2 months. Any hearing loss is most often short-term. Rarely, other problems may occur, such as:
- Long-term hearing loss
- Spread of infection to the bone behind the ear mastoiditis
- Long-term vertigo and dizziness
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Diagnosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Other Imaging Findings | Other Diagnostic Studies
Treatment
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
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