Introduction

A ruptured tympanic membrane or eardrum that has a tear or hole in it. The ear drum separates the outer ear from delicate structures of the middle ear and protecting it from cold, wind and ear wax. It receives vibrating sound waves and transmits them to the tiny bones in the middle ear. A tear or hole in the eardrum exposes the middle ear and inner ear organs to potential damage or injury. The hole also usually causes some hearing loss.

Causes

Tympanic membrane rupture can be due to infectionof external or middle ear(otits media), injury, sudden pressure changes. Among the common causes :

1. Using cotton tipped swab or sharp objects to clean ears.
2. High pressure or suction apparatus.
3. Sudden altitude or air pressure changes while flying in an air plane, swimming or diving or a nearby explosion.

Signs & symptoms

• Often there are no symptoms.
• When the rupture is caused by middle ear infection, you may feel a sudden sharp pain (built up fluid/pus in middle ear drains out) and eventually painless ear discharge.
• Rupture caused by an injury is generally discomfort from the the injury itself ,some bleeding may be noticed.
• Tinnitus
• Hearing loss
• Ear discharge

Tympanic Membrane

Otoscope examination by doctor will show a punctured eardrum and bones of middle ear, sometimes only pus is seen and may not be able to visualize the tympanic membrane properly.

Complications

• Permanent hearing loss
• Ear infection (otitis media)

Treatment

• A ruptured or perforated eardrum usually heals by it self with in 2 months. Treatment is mainly to relieve pain and prevent infection. Antibiotics may be used to prevent infection or to treat an existing infection.
• Surgical repair of the ear drum may be needed, if the eardrum does not heal on its own.

Prevention of Ear Infection

• Keep ear dry and clean while it heals.
• Cotton ball with Vaseline placed at entrance of ear canal the while showering to prevent water entering the ear.
• Silicone ear plugs while swimming. (swimming should be avoided)
• Do not insert objects into the ear canal.
• Ear infection should be treated promptly.
• Nasal symptoms may need to be treated together with the ear disease.

Last reviewed	:	26 April 2012
Writer	:	Dr. Dipaka/lBanarsi Dass
Reviewer	:	Dato’ Dr. Narizan Ariffin