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Ruptured Eardrum

The eardrum is a soft piece of soft tissue that separates the outer ear from the middle ear. It also aids in our hearing process as it vibrates when hit by sound waves. These vibrations are sent through the bones of the middle ear right to the nerve endings in the inner ear to the brain. When one has a ruptured eardrum, this process is interrupted and hearing is hindered.

A ruptured eardrum is when the said soft tissue is damaged by a tear or hole. There are various circumstances and risk factors that could cause either directly or facilitate the cause of damage to the eardrum. Some of them are mentioned below:

  • An ear infection that causes pus or fluid to accumulate behind the eardrum increasing the pressure on the eardrum. This will eventually cause it to burst which will leave behind a gaping hole. Ear infections are commonest in children, and should be watched for carefully, especially if they complain of pain in the ears.
  • Inserting foreign objects inside the ear that may cause the eardrum to tear. Such objects can be deliberate like cotton swabs used to clean the ears, while others you may not even be aware such as insects.
  • Loud noises are likely to cause injury to the eardrum. The noises may come by way of an explosion, or acoustic trauma like bad playing of a musical instrument. Also, extreme pressure such as a slap may cause damage.
  • In high altitudes such as the mountains or when flying, the pressure between the inside of the ear is different from that on the outside. This will cause the eardrum to rupture in an attempt to right this supposed wrong. This is technically known as barotraumas.
  • Severe head trauma that causes damage to the skull and areas of the ear, both the inner and outer ear including the eardrum.

The symptoms that will warn you that something is wrong with your eardrum include:

  • Interruption in the hearing or hearing loss. It may or may not be complete loss of hearing.
  • Drainage from the ear in the case of rupture is caused by an ear infection. It may be clear (pus only) or it may be bloody.
  • Pain in the ear that may gradually increase. It can range from mild to unbearable, the pain may however let up a few moments before the drainage from the ear commences.
  • There may be some buzzing in the ear and in extreme cases there will be weakness in the facial area as well as dizziness. You may be riddled with the spinning and ringing sensation in your ear as balance is upset.

Diagnosis
The doctor will use an otoscope with which he will be able to determine the status of the eardrum. If it has ruptured then he will be able to see through the hole into the middle ear. A test called audiology will be used to determine how much of the hearing one has lost.

Possible treatments
A ruptured eardrum is a very painful condition and most of the treatment is aimed at easing this pain and also treating any ear infection that might be present. Warmth to the ear eases the pain, and one should ensure to keep the ear dry at all times until it heals completely otherwise they run the risk of infecting the inner ear as well. Water over the head is not allowed during the healing process.

For the pain, one can take analgesics or over-the-counter pain medications, while for the ear infection one is expected to take antibiotics either orally or directly into the ear as drops. They also may put a patch over the eardrum to heal it faster and in extreme cases where the eardrum fails to heal, surgery may be performed by way of a tympanoplasty.

Conclusion
The ruptured eardrum in most cases heals on its own and requires no extra help. Any hearing loss experienced is temporary till you heal. However, in the case of complications, ear loss may become permanent, infection of the middle and inner ear will occur, vertigo, and infection of the bone behind the ear is possible. Also in the absence of an eardrum, a cholesteatoma with its bacteria and bone damaging protein may form and cause damage to your middle ear bones. After 2 months, if your hearing is yet to be restored then you will need to see a doctor to know what is going on.

References

  1. Perforated eardrum. American Academy of Otolaryngology – Head and Neck Surgery. http://www.entnet.org/HealthInformation/perforatedEardrum.cfm.
  2. Yates PD, et al. Otitis media. In: Lalwani AK. Current Diagnosis and Treatment in Otolaryngology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies. 2008.
    http://www.accessmedicine.com/content.aspx?aID=2830509.
  3. Bauer CA, Jenkins HA. Otologic symptoms and syndromes. In: Cummings CW, Flint PW, Haughey BH, Robbins KT, Thomas JR, eds. Otolaryngology: Head & Neck Surgery. 4th ed. Philadelphia, PA: Mosby Elsevier; 2005:chap 126.

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