Definition

The eardrum (tympanic membrane) is a thin, oval-shaped membrane measuring approximately 8–10 mm in diameter and less than 0.1 mm in thickness. It is located at the end of the external auditory canal and separates the outer ear from the middle ear.

A perforated eardrum is a condition in which the tympanic membrane is torn or has a hole. This reduces the ear’s ability to transmit sound and allows bacteria, dirt, and water to enter the middle ear, increasing the risk of infection and other complications.

Causes

Middle ear infection (otitis media)

Otitis media often leads to fluid accumulation in the middle ear. The pressure from this fluid may cause the eardrum to rupture.

Physical trauma to the head or ear

Few people realize how thin the eardrum is and how easily it can be damaged by trauma to the head or ear. In severe cases, the inner and middle ear may also be affected.

Barotrauma

Sudden changes in air pressure, such as during air travel, scuba diving, being struck directly on the ear, or airbag deployment in car accidents, can cause eardrum perforation.

Loud noise or explosions (acoustic trauma)

High-energy sound waves from explosions or gunshots can tear the eardrum.

Foreign objects in the ear

Small objects such as cotton swabs or metal ear-cleaning tools may puncture or tear the eardrum.

Symptoms

  • Severe ear pain (often decreases after the eardrum ruptures)
  • Sudden temporary hearing loss in the affected ear
  • Bleeding or discharge from the ear
  • Ringing in the ear (tinnitus) or a whistling sound
  • Dizziness

Treatment

In many cases, a perforated eardrum does not require treatment because it can heal naturally within several weeks or months if the ear is kept dry and free from infection. Most small perforations heal within 2–6 weeks.

In severe cases that significantly affect hearing, surgical repair of the eardrum (myringoplasty) may be required.

Postoperative Care After Eardrum Repair

Daily activities

  • Keep the head elevated during the first few days after surgery to reduce swelling.
  • Do not allow water into the ear and do not use any ear drops unless prescribed (keep the ear dry).
  • Do not blow your nose or hold your mouth closed when sneezing.
  • Avoid air travel for at least 1 month.
  • Avoid heavy work or strenuous activities during the first few days after surgery.
  • Do not swim or bathe in rivers, pools, or the sea.

Diet

Avoid hard, spicy, hot foods and stimulants (such as alcohol or caffeine). Follow any special dietary instructions if there are accompanying medical conditions.

Follow-up Schedule

  • 1–2 weeks: suture removal and removal of Merocel packing
  • 3 weeks: removal of Spongel
  • 1 month after Spongel removal: check whether the eardrum has healed
  • 3 months: check for recurrence of perforation
  • 6 months: evaluate complete healing of the eardrum

Note: If any abnormal signs occur such as heavy bleeding, large amounts of ear discharge or pus, severe ear pain, or persistent hearing loss, the patient should immediately visit the nearest medical facility or consult the surgeon who performed the operation.