The eardrum is required for hearing because it detects sound waves and communicates the vibrations to the brain, but in addition it acts as a shield to seal the inner ear and keep it clear of infection. When your eardrum is fully intact, your inner ear is basically a protected and sterile place; but if it has been torn or perforated, microbes may enter and spark a major infection called otitis media.
The phrases perforated eardrum and ruptured eardrum have the same meaning. They both describe a condition whose medical name is a tympanic membrane perforation where there is a tear or puncture in the thin membrane we know as the eardrum. There are numerous ways that an eardrum may become ruptured, the commonest of which is an ear infection where the buildup of fluid pushes against the eardrum until it tears. Another common cause of punctured eardrums are foreign objects introduced into the ears. For instance, you can puncture your own eardrum with a Q-tip. Another common cause is barotrauma – the situation that occurs when the barometric pressure outside the ear is very different from the pressure inside the ear – which may occur on airplanes or in scuba. Head injuries or acoustic trauma (such as exposure to sudden explosions) may also puncture the eardrum.
The symptoms of a ruptured eardrum include ear pain (including persistent ear pain that suddenly stops, fluid draining from the ear, partial or complete hearing loss in the afflicted ear, tinnitus (ringing in the ears), and vertigo or dizziness. If you encounter any of these warning signs, see a hearing health provider, because if the eardrum is ruptured, timely and correct treatment is essential to avoid infection and hearing damage. What you risk by not having these symptoms addressed are major inner ear infections and cysts, and the potential for permanent loss of hearing.
At your appointment the health care provider will look at the eardrum with an instrument called an otoscope. Because of its internal light, the otoscope gives the specialist a clear view of the eardrum. If your eardrum has been ruptured, in most cases it will heal itself within 2 to 3 months, but during this period you should avoid swimming or diving, avoid certain medications, and attempt to avoid blowing your nose (which puts extra pressure on the eardrum). For holes along the edges of the eardrum, the specialist might want to insert a temporary dam or patch which helps prevent infection. In very rare cases, surgery may be suggested.
Your physician may also order over-the-counter pain medications such as ibuprofen or acetaminophen to deal with any discomfort. The main safety measures you can take to prevent this condition are to 1) avoid putting any foreign objects into your ear canal, even to clean them, and 2) deal with ear infections promptly by seeing a specialist.