Eardrum perforation is usually caused by a middle ear infection. The eardrum can also end up perforated by an abrupt change in the pressure either due to an increase in pressure such as diving underwater or an explosion or a reduce in pressure such as flying by plane or when a strong suction is applied to the ear canal.
A significant head injury can cause eardrum perforation especially if the base of the skull close to the ear is damaged. The eardrum might also be perforated by the insertion of objects into the ear such as a cotton swab. In addition, an obstructed Eustachian tube can also lead to perforation due to the significant imbalance of pressure.
Indications of eardrum perforation
A middle ear infection that is detrimental enough to cause perforation is quite painful due to the buildup of pus. In such cases, the perforation allows the pus to drain from the ear, thus alleviating the pressure and pain.
An eardrum perforation due to an injury can cause abrupt intense pain that is oftentimes followed by bleeding from the ear, tinnitus and hearing loss.
The hearing loss is more significant if the chain of ossicles has been disrupted or the inner ear has been damaged. Damage to the inner ear can also lead to vertigo. Pus might start to drain in 24-48 hours especially if water or other foreign materials enters the middle ear.
How is it diagnosed
The doctor will diagnose eardrum perforation by checking the ear using a special instrument called an otoscope. If possible, a hearing test is carried out before and after the treatment.
It is vital to keep the ear dry. In most cases, there is no specific treatment needed unless the injury was due to a contaminated object that entered through the perforation. In such instances, the doctor will provide antibiotic ear drops or an antibiotic that is taken orally. Antibiotics might also be used if the ear is infected.
In most cases, the eardrum heals without requiring further treatment but if it does not heal within 2 months, surgery is required to repair the eardrum. Those who have a severe injury especially one with marked hearing loss, severe vertigo or both will require surgery. In case eardrum perforation is not dealt with, the individual might develop chronic otitis media.
If there is persistent conductive hearing loss that occurs after eardrum perforation, it indicates a disruption or fixation of the ossicles that might require surgery. Sensorineural hearing loss or persistent vertigo that lasts more than a few hours after the injury can indicate that something has damaged or penetrated the inner ear.