Perforated eardrum means an eardrum with a hole in it, which can cause problem in normal hearing and cause other ear problems.

What is Perforated Eardrum?

A hole or tear in the eardrum (a thin membrane medically known as tympanic membrane that separates the ear canal and the middle ear) is called perforated eardrum.

Perforated Eardrum and hearing problems

Picture 1 – Perforated Eardrum
Source – eonmeditech

Eardrum or tympanic membrane is the membrane in the ear that vibrates to sound, the hole on it creates hearing problem. In actual sense the severity of hearing problem depends on the size of perforation. Small perforation may cause minimal loss of hearing where large perforation cause severe problem of hearing. Again with a perforation on the eardrum there is a greater risk of developing an ear infection as the eardrum acts as a barrier to bacteria and other germs that might cause harm to the middle ear.

Causes

The causes of perforated eardrum include:

• Severe infection in the middle ear which can create hole in the eardrum.
• Direct injury to the ear or with fracture in skull.
• A sudden loud noise (e.g. Explosion)
• Sudden change in air pressure or Barotraumas.
• If objects like pin, stick, Q-tip are pushed too far into the ear canal.
• The entrance of hot slag or acid into the ear.
• Grommets which are usually made up of inert material used for the ventilation of middle ear to the external ear and outside environment.

Symptoms

Symptoms of perforated eardrum may include:

• Consistent pain in the ear that stops suddenly.
• Drainage from the ear (Drainage may be pus filled, bloody or it may be clear )
• Sudden hearing loss.
• Spinning sensation.
• Vomiting as a result of vertigo.
• Ringing unusual sound in the ear.
• Facial weakness.
• Severe increase in ear discomfort.
• Whistling ear while blowing nose.

Perforated Eardrum Diagnosis

It is possible foe a doctor to diagnose perforated eardrum simply by looking in to the ear with a special torch named as otoscope, though it is sometimes difficult to observe the eardrum as in most of the cases there is a lot of inflammation, wax or infection in the ear. However the diagnosis can be any of the following:

1. Laboratory test: To be sure about if there is any bacterial or viral infection in the middle ear.

2. Tuning fork test: This test helps the doctor to take decision about the degree of hearing loss.

3. Tympanometry: This test includes the insertion of a device that usually measures the response of the eardrum with little change in pressure level inside the ear.

4. Audiology exam: Doctors prefer this test in order to measure the hearing capability of the patient at different volume levels and pitches.

Treatment for Perforated Eardrum

Before any treatment of perforated eardrum a hearing test is usually performed in order to understand the actual condition of the perforation and the hearing problems faced by the patient. In case of small perforation most otolaryngologists prefer the observation of the perforation over time to see if it closes spontaneously. In general sense the treatment can be of the following types:

1. Careful observations: As mentioned earlier that in most of the cases doctors keeps the patient in careful observations, because small perforation can be easily cured if it can be assured that there is no viral or bacterial infection. In such cases doctors advise patient to not to swim and to put something soft cotton or wool until the perforation is cured.

2. Medical treatment and drugs:  It is seen that in some cases the perforated eardrum gets infected for such conditions doctors advice some ear drop or antibiotic.

3. Surgical treatment: Surgical treatment is preferred only when there is less possibilities of the perforated drum cured by itself. There are different techniques ranging from placing effective chemicals next to the torn part of the drum for quick healing, to an operation named tympanoplasty to repair the eardrum. Tympanoplasty is considered successful in fixing the perforation, and improving hearing.

However, it is not necessary for all people suffering from perforated eardrum to have a surgery. There are many people have a small permanent perforation with almost no symptoms or significant hearing loss. Treatment is mainly preferred if there is hearing loss as this can be cured if the perforation is fixed.

Important points a patient must follow

• Try to keep the ear dry while it is healing.
• Stop blowing nose.
• Cleaning ear is unnecessary until the ear is fully healed.

Perforated Eardrum Prevention

• Protect the ears during fighting.
• Try to keep ear free from external objects.
• Try to avoid excessive noise.
• Take proper treatment if there is any middle ear infection.

References:

http://pediatrics.med.nyu.edu/conditions-we-treat/conditions/tympanic-membrane-perforation

http://www.entdoctor.co.nz/pages/eardrum.pdf