A ruptured or perforated eardrum is exactly what you might imagine: a tear or hole in the eardrum — the part of the ear that vibrates in response to sound waves. Eardrum injuries can be extremely painful and, in the worst cases, might lead to infections and hearing loss.
Fortunately, though, most eardrum injuries heal within a few weeks with no problems arising. When an eardrum won't heal on its own, surgery may be required to repair it and restore normal hearing.
How the Ear Works
The eardrum, also called the tympanic membrane, is the thin, cone-shaped piece of tissue that separates the outer ear from the middle ear. It's found at the end of the ear canal (the part that gets waxy).
The hearing process begins when the pinna (the part of the ear that's visible) funnels sound waves into the ear canal, where they hit the eardrum and make it vibrate. In the inner ear, these vibrations are converted into nerve impulses by the snail-shaped cochlea. These impulses then travel to the brain along the cochlear nerve, also known as the auditory nerve. The brain's auditory cortex receives these signals and interprets them as different sounds.
If the eardrum is perforated, it can hinder the eardrum's ability to vibrate correctly, leading to muffled or diminished hearing. Hearing loss is usually temporary and can vary in intensity based on the size and location of the injury.
Sometimes bacteria and other materials enter the middle ear through this opening and can cause an infection. Fortunately, this rarely leads to permanent hearing damage.
Many people don't know that cleaning their ears with cotton swabs is a major cause of eardrum injuries. That's because poking around in the ear canal too harshly can easily injure the eardrum's fragile tissue, especially in young children, who have very narrow ear canals. (Tip: To clean wax build-up in the ears, opt for a wet washcloth and gently wipe outside the ear canal.)
But eardrums can be injured in lots of other ways, including:
- Ear infections. An infection of the middle ear or inner ear (such as otitis media) can lead to pus or fluid buildup behind the eardrum, which can cause it to burst. This is a common cause of ruptured eardrums in children.
- High or low altitudes (barotrauma). Usually, the air pressure in the middle ear and the pressure in the environment are in balance. A sudden change in barometric pressure (such as during air travel, driving on a mountain road, or scuba diving) can be enough to rupture an eardrum.
- Loud noises (acoustic trauma). Although uncommon, loud noises (like an explosion) can sometimes produce sound waves that are strong enough to damage the eardrum. Any loud noise also can cause temporary or permanent hearing damage to the cochlea and lead to hearing loss.
- Foreign objects. Besides cotton swabs, these include hairpins and other small objects that kids can fit in their ear canals.
- Head trauma. A direct blow to the ear can cause a skull fracture or pressure that might tear the eardrum.
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2009 The Nemours Foundation. All rights reserved.
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