Eardrum rupture is a condition where a hole or a tear develops in the eardrum. Eardrum is medically known as tympanic membrane and its rupture is known as perforation of tympanic membrane.The function of the eardrum is to protect the middle and inner ear (parts of an ear) from foreign bodies, infection and water. And help in listening sound.
As an eardrum is a very thin membrane and gets perforated easily. This results in middle and inner ear being exposed to various infections and injuries and loss of hearing.
- Tympanic membrane perforation
- Eardrum perforation
CAUSES & RISK FACTORS
- Infections in the middle ear: It leads to fluid accumulation in the middle ear, exerting pressure on the eardrum. This may causes eardrum to stretch and then to rupture.
- Barotrauma: Increased pressure in the middle ear secondary to infection, airplane travel or scuba diving.
- Acoustic trauma: Sudden exposure of ear to loud sounds like from a gunshot, blast, crackers etc. can cause eardrum to rupture. It is known as acoustic trauma.
- Injury: By cotton buds, hairpin or due to trauma. Head injuries due to fall or vehicular accidents can cause fracture of the skull which in turn can cause eardrum rupture.
SYMPTOMS AND SIGNS
Eardrum rupture can cause following signs and symptoms:
- Severe ear pain which suddenly disappears. It happens with middle ear infection and pressure exerted by fluid on the middle ear. Disappears with an ear drum rupture, relieving pain.
- Pus: Infected fluid or bloody discharge from the ear.
- Tinnitus: Ringing in the ear.
- Vertigo: Dizziness with a sense of movement even in a static position.
- Nausea: Sensation of vomiting.
- Loss of hearingThe degree of hearing loss depends on the size, location and cause of the hole developed in the eardrum.
- Audiometry:It is done to measure the degree and type of loss of hearing ability. It is done with an audiometer(Instrument used for the purpose). It also measures the ability to discriminate between various sounds and pitch.
- Laboratory tests:The discharge from the ear can be collected and sent to the laboratory to check for the bacterial or viral infection that has caused the disease.
- Hearing test with tuning fork:It is performed to determine hearing loss.
- Examination with a Tympanometer:An Instrument is inserted in the ear to determine eardrum response to air pressure changes, which in turn helps in detecting eardrum rupture.
Physical Examination:An ear is examined with an otoscope (an instrument used to view magnified image of inner ear) to look for any tear of the eardrum. Ear discharge, pus, any other blockage is noted if present.
The prognosis in this condition is good if proper care is taken while the eardrum is healing. If it is left unhealed then it can cause severe complications like permanent hearing loss.
- Painkillers: Paracetamol, Ibuprofen. Aspirin if given should be used with caution.
- Antibiotics: Amoxicillin is a first choice. Other antibiotics used are azithromycin cefdinir, cefuroxime, cefpodoxime, amoxicillin clavulanate (Augmentin)
- Local heat therapy: Warm padding kept over ear
- Eardrum repair using a patch:Its an OPD (Outpatient department) procedure. Doctor applies a chemical on ends on the tear to facilitate its growth and then covers it with a patch(of paper, muscle, fat, etc).
- Tympanoplasty:It is a surgical method of repairing the eardrum rupture with a graft obtained from the patient’s own tissue. It is performed on an OPD basis.
Care of ruptured ear drum:
- Patient should keep his ear dry by covering the ear with cotton plug, using a shower cap while bathing and by avoiding diving or swimming.
- Ears should be cleaned carefully without a use of any sharp objects.
- Blowing nose forcefully is avoided.
COMPLICATIONS OF DISEASE
- Permanent hearing loss.
- Severe infections which take time to heal.
- Spread of infections elsewhere in the body like brain which complicates the situation further.
- Cyst formation in the middle ear:Its known as a Cholesteatoma which can easily get infected and cause damage to hearing bones.
Rupture of an eardrum can be prevented by taking following precautions:
- Prompt treatment of ear/nose/throat infections.
- Covering ears in long journeys.
- Avoiding diving and swimming when already suffering from ear/nose/throat infections.
- While in a plane,use of air pressure balancing techniques like chewing gum,pressure equalizing earplugs,yawning.
- Avoid cleaning the ear with sharp objects.
- Use of protective devices for sports that can harm eardrum due to the fall.
Lustig LR, et al. Ear, nose and throat disorders. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment. 50th ed. New York, N.Y.: The McGraw-Hill Companies. 2011.