A middle ear infection (otitis media) is the most common cause of eardrum perforation. The eardrum can also be perforated by a sudden change in pressure?either an increase, such as that caused by an explosion, a slap, or diving underwater; or a decrease, such as occurs while flying in an airplane. Another cause is burns from heat or chemicals.

The eardrum may also be perforated (punctured) by objects placed in the ear, such as a cotton-tipped swab, or by objects entering the ear accidentally, such as a low-hanging twig or a thrown pencil.

Symptoms:

Perforation of the eardrum causes sudden severe pain, sometimes followed by bleeding from the ear, hearing loss, and noise in the ear

A doctor diagnoses eardrum perforation by looking in the ear with a special instrument called an otoscope. Sometimes formal hearing tests are performed.

Treatment:

The ear is kept dry. An antibiotic given by mouth may be used if the ear becomes infected. Ear drops may be given for contaminated injuries. Usually, the eardrum heals without further treatment, but if it does not heal within 2 months, surgery to repair the eardrum (tympanoplasty) may be needed.

A persistent conductive hearing loss (see Hearing Loss and Deafness) occurring after perforation of the eardrum suggests a disruption or fixation of the ossicles, which may be repaired surgically