Ear
Perforated Eardrum
A perforated eardrum is a hole or tear in the thin membrane separating the ear canal from the middle ear. The eardrum vibrates in response to sound, helping transmit it through the middle ear. A perforation can affect hearing and make the middle ear more vulnerable to infection.
Many perforations heal naturally, while others require monitoring or repair.
What Can Cause It?
A perforation may develop after:
- A middle ear infection.
- An injury caused by an object inserted into the ear.
- A blow to the ear or a significant head injury.
- A sudden pressure change or blast.
Sometimes, a small opening remains after a ventilation tube comes out. Understanding how the perforation developed helps guide assessment and treatment.
What Symptoms Can Occur?
Possible symptoms include reduced hearing, ear pain, ringing or buzzing, and fluid or blood draining from the ear. Some people also experience dizziness.
The effect on hearing varies. A small perforation may cause little difficulty, whereas a larger opening or associated damage to the middle ear can have a greater impact. Examination is needed to establish the cause and extent of any hearing change.
How Is It Assessed?
An ENT assessment includes a review of symptoms, previous infections and any recent injury. The eardrum is examined using an otoscope, microscope or endoscope to assess the opening and surrounding tissue.
Hearing tests help measure hearing levels and investigate whether other parts of the hearing system may be affected. Additional investigations are selected according to the findings rather than being required for every perforation.
Will It Heal Without Surgery?
Many recent perforations close within several weeks, although healing can take longer. Follow-up helps confirm whether the opening has closed and whether hearing has recovered.
If infection is present, a clinician may prescribe treatment suitable for a perforated eardrum. Do not use ear drops unless a healthcare professional has confirmed that they are appropriate.
When Might Repair Be Considered?
A persistent perforation, recurring discharge or ongoing hearing difficulties may lead to a discussion about repair.
Selected perforations may be treated with a patch. Surgical repair, called myringoplasty or tympanoplasty depending on the extent of the procedure, uses a graft to close the opening. Some patients also need treatment of associated middle ear damage.
The approach, expected benefits and risks depend on the examination and hearing results. Closure and hearing improvement cannot be guaranteed.
Protecting Your Ear During Healing
Keep the ear dry and avoid swimming until a clinician confirms it is safe. When washing, petroleum-jelly-coated cotton wool can be placed at the ear entrance without pushing it into the canal.
Avoid cotton buds, cleaning inside the ear and forceful nose blowing. Attend follow-up even if discomfort settles.
When Should You Seek Medical Advice?
Seek urgent assessment for sudden hearing loss, rapidly worsening hearing, or hearing loss accompanied by pain or discharge. Do not assume that a sudden change is caused only by a perforation.
Arrange reassessment if symptoms are not improving or discharge keeps returning.
Discuss Your Symptoms
Contact the clinic to arrange an assessment and discuss healing, hearing and whether further treatment may be appropriate.
This information provides general guidance and does not replace an individual medical assessment.
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