Perforated eardrum

Overview

A perforated or burst eardrum is a hole in the eardrum. It'll usually heal within a few weeks and might not need any treatment.

But it's a good idea to see a GP if you think your eardrum has burst, as it can cause problems such as ear infections.

Symptoms of a perforated eardrum

Signs of a perforated eardrum or ear infection caused by a perforated eardrum include:

sudden hearing loss – you may find it difficult to hear anything or your hearing may just be slightly muffled
earache or pain in your ear
itching in your ear
fluid leaking from your ear
a high temperature
ringing or buzzing in your ear (tinnitus)

The symptoms will usually pass once your eardrum has healed and any infection has been treated.

When to see a GP

See a GP if:

you think you have a perforated eardrum
you have already seen a GP and your symptoms are not any better after a few weeks or you get new symptoms (such as earache, a fever, itching or fluid leaking from the ear)

Your eardrum will usually heal without treatment, but a GP can check for an infection (which may need treatment) and talk to you about how you can look after your ear.

They'll look into your ear using a small handheld torch with a magnifying lens. The tip of this goes into your ear, but it only goes in a little way and should not hurt.

Things you can do if you have a perforated eardrum

Perforated eardrums do not always need to be treated because they often get better by themselves within a few weeks.

While it heals, the following tips can help you relieve your symptoms and reduce the chances of your ear becoming infected:

do not put anything in your ear, such as cotton buds or eardrops (unless your doctor recommends them)
do not get water in your ear – do not go swimming and be extra careful when showering or washing your hair
try not to blow your nose too hard, as this can damage your eardrum as it heals
hold a warm flannel against your ear to help reduce any pain
take painkillers such as paracetamol or ibuprofen to relieve pain if you need to (do not give aspirin to children under 16)

Treatments for a perforated eardrum

If you have an ear infection caused by a perforated eardrum, a GP may prescribe antibiotics.

If the hole in your eardrum is big or does not heal in a few weeks, a GP may refer you to an ear specialist to talk about having surgery to repair a perforated eardrum.

Causes of a perforated eardrum

A hole in the eardrum can be caused by:

an ear infection
an injury to the eardrum, such as a blow to your ear or poking an object like a cotton bud deep into your ear
changes in air pressure, such as while flying or scuba diving
a sudden loud noise, such as an explosion

The following tips may help you avoid damaging your eardrum:

see a GP for treatment if you have symptoms of an ear infection for more than 2 or 3 days
do not push anything deep into your ears, including your fingers
wear suitable ear protection if you're often exposed to loud noises
when flying, try swallowing, yawning, chewing gum or sucking on a boiled sweet during take-off and landing

Surgery

You may need surgery to repair your perforated eardrum if the hole in your eardrum is large or doesn't heal in a few weeks

The type of operation you'll have is called a myringoplasty.

What happens during surgery for a perforated eardrum

Surgery to repair a burst eardrum is usually carried out in hospital under general anaesthetic (where you're asleep).

During the procedure:

a small cut is made just in front or behind your ear and a small piece of tissue is removed from under your skin – this will leave a small scar, which will usually be covered by your hair
small surgical instruments are used to patch the hole in your eardrum with this piece of tissue – this may be done through your ear opening, or through a small cut made next to your ear
a dressing is placed in your ear to hold the patch in place and stop water and germs getting in – this usually stays in place for about two or three weeks
cotton wool padding is put over your ear and held in place with a bandage
the cut(s) in your skin are closed with stitches

Most people can go home on the same day or the day after the operation.

Recovering from surgery for a perforated eardrum

It usually takes a few weeks for your eardrum to heal.

A follow-up appointment for about two or three weeks after your operation will be arranged before or soon after leaving hospital.

Looking after yourself

After the operation:

make sure someone stays with you for the first 24 hours – don't drive or drink alcohol during this time
change the cotton wool in your ear every day (but leave the dressing that's deeper in your ear in place)
avoid getting your ear wet – place cotton wool covered in petroleum jelly (such as Vaseline) in your ear when showering
you may need to stay off work (or school) for about a week – you might be off for longer if your job involves lots of moving or bending over
after about a week, speak to your GP surgery about getting your stitches removed (if they don't dissolve by themselves)

Activities to avoid

Until you've had your follow-up appointment, avoid:

flying
swimming
smoking
close contact with sick people – you could pick up an ear infection
sports and other strenuous activities
blowing your nose too hard – if you need to sneeze, try to keep your mouth open to reduce the pressure in your ear

Your doctor or nurse will advise you when to return to normal activities.

When to get medical advice

It's normal to have some discomfort, dizziness, unusual noises in your ear and a little bleeding for the first few days after surgery.

Contact the hospital or your GP if:

you have lots of fluid or blood coming from your ear, particularly if the fluid smells bad
you have pain that's severe and isn't relieved with painkillers
you feel very dizzy or the dizziness doesn't improve in a few days
your ear is red, swollen and itchy

Risks of surgery for a perforated eardrum

Surgery to repair a perforated eardrum doesn't usually cause any serious problems.

But possible risks include:

a wound infection, which can cause pain, bleeding and leaking of fluid – contact the hospital or your GP if you have these symptoms
ringing or buzzing in your ear (tinnitus) – this usually improves in time, but can sometimes be permanent
changes in taste – these are usually temporary, but can occasionally be permanent
worse hearing or hearing loss – although permanent hearing loss is rare
inability to move muscles in part of the face – this may get better over time, but can be permanent in rare cases

Before you have surgery, talk to your surgeon about the possible benefits and risks of the operation.

The information on this page has been adapted by NHS Wales from original content supplied by

NHS website nhs.uk