Your eardrum is a membrane that separates the outer ear from the middle ear, and it plays a critical role in hearing. If the membrane is torn or gets a hole in it, it’s known as a perforated eardrum. This can affect your hearing, so it’s important to understand what a perforated eardrum is, what causes it and how to treat it before it causes irreversible hearing damage.
What Causes a Perforated Eardrum
The eardrum is fragile, and it can be easily torn if something damages it or there’s a change in pressure. The most common causes are:
- Middle ear infection, or otitis media. When fluid builds up behind the eardrum, it creates pressure and makes for the perfect environment for bacteria to fester.
- Punctured by a foreign object.Objects in the ear canal, from your finger to a cotton swab to compacted earwax, can break through the eardrum. This is why you should never clean your ears with a cotton swab.
- Ear injury or trauma. A hard hit to the ear or side of the head can tear the eardrum.
- Loud noise. Loud noises, such as gunfire or explosions, have wide, forceful sound waves that enter the ear canal like a hurricane. With that much power, it can blow a hole straight through the eardrum.
- Pressure changes. The cavity behind the eardrum, the middle ear, is incredibly sensitive to differences in pressure between the inside of your head and the outside. A sudden change of pressure can cause the eardrum to burst.
How to Tell You Have a Perforated Eardrum
Here are the most common symptoms of a perforated eardrum:
- Changes in hearing, such as sounds appearing muffled or like they’re underwater
- Fluid draining from the ear. In some cases, this discharge may turn brown or reddish-brown due to blood being present.
- Ear pain
- Itching in the ear
- Tinnitus, or a ringing or buzzing in the ear
- Dizziness or vertigo
In some cases, especially with a middle ear infection, the moment your eardrum ruptures can provide some amount of relief, as it quickly releases the pressure that has built up behind it.
Hearing Loss Caused by a Perforated Eardrum
A perforated eardrum directly affects hearing. When sound waves enter the ear, they are funneled down the ear canal and strike the eardrum. Once hit, the membrane vibrates (just like a drum), and those vibrations travel deeper into the ear to be collected and perceived as sound.
In order to vibrate, the membrane must be intact and taut. This way, it can channel its vibrations into the inner ear. If it cannot do this, sound waves can still get into the middle and inner ear, but they’ll be weakened and won’t be channeled along the proper pathways. This leads to hearing loss—specifically, conductive hearing loss.
Hearing loss caused by a perforated eardrum can vary in intensity, can happen in one ear or both, and it can be temporary or permanent. It all depends on how severely the eardrum was damaged and whether it can heal properly.
How to Treat a Perforated Eardrum and Hearing Loss
In many cases, a perforated eardrum heals on its own without medical intervention, and if it heals properly, hearing should return to normal. Help it heal properly by keeping your ear dry and not cleaning it, even gently, as this can disturb the healing process. If it’s been over a week and it doesn’t seem to be healing, or if the symptoms aren’t improving or are worsening, consult your primary care provider or an ENT specialist to treat the eardrum and mend the tear.
If the tear is large or if it doesn’t heal properly, it can cause permanent hearing damage. Additionally, some of the things listed above that can cause a perforated eardrum can also cause hearing loss in their own right, such as loud noise exposure or ear or head trauma. In any case, if you notice a change in your hearing abilities, it’s important to seek help straightaway. Contact Aaron's Hearing Aid & Audiology Center to learn more.