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What is Ruptured Eardrum? Print E-mail
Written by Mike Cohen   
Wednesday, 11 November 2009

A perforated eardrum occurs when there is an opening in the membrane that separates the ear canal from the middle ear.

What is going on in the body?

The eardrum is the dividing line between the external and middle ear. The external ear is formed by the auricle, which is the external ear flap, and the external ear canal. The middle ear is the air-filled space behind the eardrum that contains the three small bones for hearing. The eardrum is an important barrier between the environment and the middle ear. It also vibrates to transmit sound, part of the normal hearing mechanism.

The eardrum may be ruptured due to trauma, such as a sharp blow to the external ear. It can also rupture when pressure builds up in the middle ear and pushes the eardrum outward.

What are the causes and risks of the condition?
Following are some of the common causes of a ruptured eardrum:
_ changes in barometric pressure, caused by activities such as flying in a plane or scuba diving
_ ear infections, especially if the infections are severe
_ holes left in the eardrum when ear tubes have fallen out and the eardrum doesn't repair itself
_ insertion of cotton applicators or other small objects into the ear canal
_ previous ruptures
_ sudden explosion
_ trauma, such as sports injuries that cause a blow to the side of the head
_ tuberculosis
_ welding burns from hot slag entering the ear canal

Sometimes, the eardrum is deliberately perforated when ear tubes are placed. A surgeon places these small tubes into the eardrum when a person has chronic ear infections. They allow drainage of infected material from the middle ear and lower the pressure within the middle ear.

What are the treatments for the condition?
When a hole in the eardrum is diagnosed, it is important to take the following steps.
_ Avoid blowing the nose.
_ Avoid changes in elevation.
_ Keep contaminated or soapy water out of the ear canal.

Most ruptures caused by trauma, ear infections, and ear tubes will heal on their own. But some ruptures may require surgery. Patches of paper or fat are used to repair small holes. For larger holes, tissue is usually taken from the chewing muscle located in the temple. This tissue is then placed under the eardrum or on its surface. It acts as a scaffold for the drum to heal over.

What are the side effects of the treatments?

Surgery may cause bleeding, infection, or allergic reactions to anesthesia. Ear surgery may also cause hearing impairment.

What happens after treatment for the condition?
If treatment is successful, the protective barrier effect of the eardrum is restored. The person's hearing returns to a completely normal state.

How is the condition monitored?
Hearing should improve as the hole closes. If this does not happen, there may be another rupture. Anyone with a known rupture who gets water in the middle ear should use antibiotic eardrops to prevent an ear infection.

A person who has continued or recurrent episodes of ear drainage may have a chronic ear infection. The healthcare provider should be consulted. Any other new or worsening symptoms should also be reported to the provider.


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