Eardrum rupture: causes and consequences

The rupture of the tympanic membrane is the mechanical damage to the thin tissue that separates the auditory canal and the middle ear. As a result of such an injury, a person can completely or partially lose his hearing. In addition, without natural protection, the middle ear remains vulnerable to infections and other physical injuries. As a rule, a hole or a breakthrough in the eardrum overgrows on its own within a few weeks, and treatment is not required. In difficult cases, doctors prescribe special procedures or surgery to ensure normal wound healing.

Symptoms

Signs of rupture of the eardrum are as follows:

• Pain in the ear, which can abruptly begin and abruptly disappear.
• Clear, purulent, or bloody discharge from the ear.
• Hearing loss.
• Ringing in the ear (tinnitus).
• Dizziness (vertigo).
• Nausea or vomiting as a result of dizziness.

When to see a doctor

Sign up for a consultation at a clinic or health care center if you find that you have characteristic symptoms of a rupture or minor damage to the eardrum, as well as if you feel pain or discomfort in your ears. The middle ear, as well as the inner one, consists of very fragile fragments and is vulnerable to diseases and injuries. Adequate treatment in a timely manner is paramount to maintaining normal hearing.

Causes

The main causes of rupture of the eardrum can be combined in the following list:

• Middle ear infection (otitis media). As a result of an infectious disease, fluid accumulates in the middle ear, which exerts excessive pressure on the eardrum and thereby causes damage to it.
• Barotrauma is damage resulting from strong tension of the thin tissue, provoked by the pressure difference in the middle ear and in the environment. Too much pressure can tear the eardrum. Closely connected with barotrauma is the so-called stuffy-ear syndrome, from which almost all passengers of air transport suffer. Differential pressure is also characteristic of scuba diving. In addition, any direct blow to the ear is potentially dangerous, even if the airbag in the car has fired.
• Low sounds and explosions (acoustic trauma). The rupture of the eardrum, the symptoms of which will be evident in the blink of an eye, often occurs under the influence of too loud sounds (explosions, shooting). An excessively powerful sound wave can seriously damage the delicate structure of the ears.
• Foreign objects in the ear. Small objects like a cotton swab or hair clips can pierce and even tear the eardrum.
• Severe head injury. Traumatic brain injuries cause dislocation and damage to the structure of the middle and inner ear, including rupture of the eardrum. The head may crack the skull, it is this circumstance that most often serves as a prerequisite for a breakthrough in thin tissue.

Complications

The eardrum has two main functions:

• Hearing. When sound waves hit the membrane, it begins to vibrate. The structures of the middle and inner ear recognize these vibrations and translate sound waves into nerve impulses.
• Protection. The eardrum also acts as a natural protective barrier, protecting the middle ear from the ingress of water, bacteria and other foreign substances.

In trauma, complications can occur both in the healing process and in the event that the tympanic membrane cannot completely overgrow. Potentially possible:

• Hearing loss. As a rule, the hearing disappears only for a while, until the hole in the eardrum disappears on its own. However, many patients of otorhinolaryngologists note a marked decrease in hearing quality even after a complete overgrowth of the breakthrough. Much depends on the location and size of the wound.
• Middle ear infection (otitis media). Rupture of the eardrum in a child or adult facilitates access of bacteria into the auditory canal. If the tissue does not heal itself, and the patient does not seek medical help, there is a high risk of developing untreatable (chronic) infectious diseases, which can ultimately lead to complete hearing loss.
• Cyst of the middle ear (cholesteatoma). A cholesteatoma, or pearl tumor, is a cyst consisting of skin cells and necrotic tissue. If the eardrum is damaged, dead skin cells and other organic debris can enter the middle ear and form a cyst. The cholesteatoma provides a favorable environment for the propagation of harmful bacteria and contains proteins that can weaken the bones of the middle ear.

Before a visit to the doctor

When it seems to you that a tympanic membrane has ruptured, the symptoms allow you to relatively accurately judge the presence of injury. If your hearing quality has noticeably decreased, make an appointment with a specialist. You can first visit a therapist, however, to save time, it is recommended to immediately go to an appointment with an otorhinolaryngologist.

Before visiting a specialist, it is advisable to think about what you are going to tell about your ailment. In order not to forget anything, record the key information in writing. Describe in detail:

• symptoms that concern you, including those that you think are not related to damage to the eardrum and are not associated with hearing loss, watery discharge, and other typical signs of injury;
• recent cases in your life that could have caused ear damage, including infectious diseases, sports injuries, or air travel;
• medicines, including vitamin-mineral complexes and biologically active food additives that you are taking at the moment;
• Questions to ask your doctor.

If you suspect a tympanic membrane rupture due to otitis media or from a stroke, consider asking the otorhinolaryngologist the following questions:

• Is my eardrum torn?
• If not, for what reason did my hearing worsen and other symptoms of the disorder occur?
• If the eardrum is damaged, what should I do to protect my ear from possible infections during the process of its natural healing?
• Do I need to make an appointment again to check how well the tissue has healed?
• When will it be necessary to consider the appointment of specific treatment methods?

Feel free to ask other questions to a specialist.

What the doctor will say

An ENT specialist, in turn, will be interested in the following:

• When did you first notice the symptoms of injury?
• Rupture of the eardrum of the ear is often accompanied by pain and characteristic dizziness. Have you noticed similar signs of tissue damage? How fast did they go?
• Have you suffered infections of the ears?
• Have you been exposed to too loud sounds?
• Have you been swimming in a natural body of water or in a swimming pool lately? Did you dive with scuba diving?
• Have you recently traveled by plane?
• When was the last time you got a head injury?
• How do you clean your ears? Do you use any items for cleaning?

Before consultation

If the appointment with the ENT specialist has not yet arrived, and you suspect that your eardrum is ruptured from a stroke, you should not start treatment on your own initiative. It is best to take all possible measures to prevent infectious diseases of the ear. Try to keep your ears clean and dry, refrain from swimming, make sure that water does not get inside the auricle while bathing in the bath or taking a shower. To protect a damaged ear during water procedures, insert elastic waterproof silicone earplugs or a cotton ball soaked in petroleum jelly each time.

Do not use any ear drops purchased at the pharmacy in your sole discretion; medication can only be prescribed by a doctor and only for the treatment of infectious diseases associated with damage to the eardrum.

Diagnostics

To determine the presence and degree of damage, the ENT usually examines the ear visually using a special instrument with illumination - an otoscope. If during a surface examination it is not possible to accurately determine the cause or extent of the rupture, the doctor may prescribe additional diagnostic examinations, including:

• Lab tests. If you notice discharge from a damaged ear, an ENT specialist will probably prescribe a laboratory test or cultivation of a sample of the discharge to determine the type of infection that has affected the middle ear.
• Evaluation of hearing using a tuning fork. Tuning forks are double-toothed metal instruments that make a sound when struck. A simple examination with their help will allow the doctor to diagnose hearing loss. In addition, the use of a tuning fork allows you to determine what caused the hearing loss: damage to the vibrating parts of the middle ear (including the eardrum), trauma to the receptors or nerves of the inner ear, or all together.
• Tympanometry. A tympanometer is a device that is placed in the ear canal to assess the reaction of the eardrum to minor changes in air pressure. Certain reaction patterns may indicate rupture of the eardrum, the symptoms of which in some cases do not even cause much concern to the patient.
• Audiological examination. If other tests and analyzes have not yielded significant results, the doctor will prescribe an audiological examination, which means a series of strictly verified tests conducted in a soundproofed cabin to assess the patient's perception of sounds of different volumes and at different frequencies.

Treatment

If you have been diagnosed with a normal eardrum rupture that is not complicated by infection, the consequences are likely to be most favorable: in the worst case, only a slight hearing loss on the affected side awaits you. If there are signs of infection, the doctor will prescribe an antibiotic in the form of ear drops (Otipax, Sofradex, Otinum). If the breakthrough does not grow on its own, you may have to resort to special procedures to ensure complete healing of the eardrum. ENT may prescribe:

• The application of a special patch on the eardrum. This is a fairly simple procedure in which the doctor treats the edges of the gap with a substance that stimulates cell growth, and seals the damage with a special material that serves as a kind of patch for injured tissue. Most likely, you will have to repeat this action several times before the eardrum finally heals.
• Surgery. If applying the patch did not help or the doctor seriously doubts that a simple procedure will help heal the rupture of the eardrum, he will recommend you treatment through surgery. Most often, an operation called tympanoplasty is performed. The surgeon will make a cut over the ear, remove a tiny flap of tissue and close it with a gap in the eardrum. This is a simple operation and most patients return home the same day.

At home

It is not always necessary to consult a specialist for medical advice and diagnosis. For many people with a tympanic membrane rupture, the treatment is only to protect the injured ear from new injuries and to prevent possible infections. The process of self-healing takes several weeks. Regardless of whether you contacted the otorhinolaryngologist or not, take all possible measures to protect the damaged ear from complications. Doctors recommend following these rules:

• Keep your ear dry. Each time you take a bath or shower, insert waterproof silicone ear plugs or a cotton ball soaked in petroleum jelly into the outer ear .
• Refrain from cleaning. Do not use any substances or items to clean your ears, even if they are specifically designed for this purpose. Give your eardrum time to heal completely.
• Do not blow your nose. The pressure created by blowing can damage an already injured tissue.

Prevention

To prevent eardrum rupture, follow these guidelines:

• treat infectious diseases of the middle ear in a timely manner;
• provide your ears with adequate protection when traveling by air;
• Avoid cleaning your ears with foreign objects, including cotton buds and paper clips;
• Wear headphones or ear plugs if your work involves excessive loud noise.

Following these simple tips will protect your eardrums from damage.