Dr Sonia's ENT

ENT Specialist, Head & Neck Surgeon,Bangalore
Dr Sonia Suprabha Venugopal

ENT Health Articles

Ear drum perforation- causes,symptoms,line of action

Posted on July 27, 2010 at 12:19 AM

Ear drum perforation- causes,symptoms,line of action

By Dr Sonia Suprabha Venugopal, ENT Specialist Bangalore

The ear drum is a thin delicate membranous structure situated deep within the ear canal and separates the outer ear canal from the delicate middle and inner ear.Due to its delicate nature the ear drum can get ruptured by various causes even a slpa on the ear can rupture the ear drum.

See Article on Ear drum-What is the ear drum?

What are the causes of an ear drum perforation[ ear drum hole]?

  • Middle ear infection
  • Eustachian tube dysfunction[ the eustachian tube is a tube which connects the middle ear with the nasopharynx[back of the nose]The picture below shows diagramatically how the eustachian tube connects the middle ear and the nose.
  • Injury- slap ,fall on the side of the head,injury with ear buds[See Article on Ear bUds and You ,injury with sharp objects inserted into ear,sports injury,motor vehicle accidents,head injury can injure the ear drum and produce an ear drum hole
  • Lightning injury
  • Very loud sound Blast waves from gunshots, fireworks, explosions can produce an ear drum perforation
  • Pressure changes- such as in diving or air travel can injure and rupture the ear drum due to pressure inequalisation between the middle ear and the external ear canal

Can the ear drum perforate due to a cold[upper respiratory tract infection]?

Yes it can!

During a heavy or prolonged "cold ",infection can be transmitted to the middle ear from the nose via the eustachian tube .Fluid collects in the middle ear and since the middle ear is enclosed in a narrow bony crevice fluid build up in the narrow area stretches the ear drum which can easily burst at the peak of fluid accumulation.The ear drum perforation is preceeded by ear pain and the perforation can even releive the pain to some extent as the fluid build up is released.This may give the patient a false impression that all is well but tell tale signs are-

  • Bleeding due to the rupture of the ear drum [ this may be anly a few drops or as a blood stained ear discharge ],
  • Hearing loss[may be mild as to be unnoticeable .

Other symptoms which may or may not be present in ear drum perforation are

  • Tinnitus
  • Dizziness
  • Imbalance mild
  • Spinning sensation[vertigo]
  • Ear fullness

If there is severe middle ear infection also the ear drum can perforate due to pus accumulationin the middle ear which can put presure on the ear drum, thin the ear drum and perforate it.

What are the signs and symptoms of an Ear drum perforation due to injury?

A slap or fall on the side of the can produce an ear drum perforation.Symptoms in such cases :-

  • Ear discomfort
  • Ear pain[need not be present]
  • Ear fullness
  • Hearing loss [may not be noticeable sometimes]
  • Tinnitus [sounds in the ear]
  • Ear discharge [blood stained ]- very mild as to be unnoticeable often
  • Bleeding - usually only a few drops

What are the symptoms of an old ear drum perforation?

You may be having an ear drum perforation for sometime [mostly due to previous ear infection which has not healed]- what are the symptoms in such a case?

  • Ear discharge on and off - especially when there is a 'cold'[upper respiratory infection] or there is some water entry into the ear
  • Hearing loss [ often denied and goes unnoticed as the other ear if normal makes up for the Hearing loss ]
  • Tinnitus [may or may not be present]
  • Dizziness [may come and go]

What is to be done in a old ear drum hole?

You need to meet an ENT Specialist and get your ears evaluated.In the presence of an ear drum perforation not only can the hearing deteriorate but there is always a risk of serious infection.Sometimes if the ear drum perforation is small medical ear drum closure is possible with special direct otoendoscopic medication application.Sutureless ear drum surgery is a sophisticated daycare procedure which can be performed with ease by an ENT specialist with specialised qualification in the same.

What is to be done if you suspect an ear drum perforation[recent] in yourself or your child?

Do not let water enter the ears till your suspicions are cleared

Do not put oil or other liquids into the ear canals

Continue all cold medications you or your child is already taking

Visit your ENT Doctor at the earliest as timely treatment gives the best results and prevents complications.


Dr Sonia Suprabha Venugopal

Consultant ENT and Head and Neck Surgery

Dr Sonia & Dr Prateek's ENT ,Head & Neck Center



Categories: Ear , Paediatric ENT