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Perforated eardrum

Introduction

Perforated eardrum

A perforated eardrum is a hole or tear in the eardrum. It can be uncomfortable, but usually heals within a few weeks or months provided your ear is kept dry and there’s no infection.

The eardrum, also known as the tympanic membrane, is a thin layer of tissue that separates the outer ear from the middle ear.

A hole in the eardrum can be caused by:

  • middle ear infection, if pus builds up inside your ear and puts pressure on your eardrum
  • an injury to the eardrum, such as a severe blow to the ear or poking an object such as a cotton bud deep into the ear
  • a sudden loud noise, such as a loud explosion
  • changes in air pressure, such as pressure changes while flying at high altitude or when scuba diving

Signs and symptoms

One of the main symptoms of a perforated eardrum is hearing loss. This can vary in severity, depending on the size of the hole, and usually goes back to normal once your eardrum has healed.

Some people also have symptoms of a middle ear infection, such as:

  • earache or discomfort
  • a discharge of mucus from your ear
  • a high temperature (fever) of 38C (100.4F) or above

You may have some ringing or buzzing in your ear (tinnitus) as well.

When to see your GP

See your GP if you have persistent symptoms of a perforated eardrum.

Although your eardrum will usually heal itself eventually, treatment may be necessary to prevent infections and help improve your hearing.

Your GP will use a special instrument called an auriscope or otoscope to examine your eardrum. These have a light and a lens that allow your GP to see any holes or tears in the eardrum.

Treating a perforated eardrum

Perforated eardrums don't always need to be treated because they normally heal by themselves in a few weeks or months provided that your ear is kept dry and there’s no infection.

If you have any pain or discomfort, you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Never give aspirin to children under 16.

Placing a warm flannel against the affected ear may also help relieve the pain.

Your GP may prescribe antibiotics if your perforated eardrum was caused by an infection or if there is a risk that an infection will develop while your eardrum heals.

You can reduce your risk of developing an infection by keeping your ear dry until it's healed. Don't go swimming, and cover your ears when having a shower.

You may need surgery to repair your eardrum if the hole is particularly large or doesn't heal. The procedure used to repair a perforated eardrum is known as a myringoplasty.

Read more about surgery for a perforated eardrum below.

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Surgery

You may need surgery if your perforated eardrum is severe or doesn't heal. The procedure used to repair a perforated eardrum is known as a myringoplasty.

This can help reduce your risk of getting ear infections and may help improve your hearing.

If your GP refers you to a consultant for specialist treatment such as surgery, you have the right to start treatment within 26 weeks of your referral. Read more about NHS waiting times for treatment.

The procedure

Before a myringoplasty, you'll be admitted to the specialist ear, nose and throat (ENT) department of your local hospital.

The procedure is normally carried out under general anaesthetic. The surgeon uses a microscope and very small surgical equipment to seal the hole in your eardrum with a small piece of tissue (graft), which is usually taken from just in front or behind your ear.

Sometimes, a cut is made behind your ear so the surgeon can access your eardrum more easily.

After the procedure, a dressing will be placed inside your ear canal and cotton wool padding will be put over your ear and held in place with a bandage. You may also have some stitches.

Recovery

Most people can go home from hospital on the same day or the day after the procedure, but you may need to stay off work or school for up to two weeks.

You'll be advised about changing the cotton wool padding over your ear and about any activities you need to avoid while you recover. Generally, you should try to avoid blowing your nose too hard and make sure you keep the ear dry.

Don't go swimming and plug your ear with cotton wool covered with Vaseline when you have a shower or bath. Don't fly until advised it's safe to do so. You should usually wait at least three months from the time of surgery. For more information, see below. You may experience some short-lived dizziness after the procedure and the dressing in your ear will make it difficult to hear properly. You shouldn't have too much pain, but you can take painkillers if necessary.

If your stitches aren't ones that dissolve on their own, you'll have an appointment about a week later to remove these.

A few weeks after your operation, you will have an appointment at the outpatient clinic to have your dressings removed and your ear checked.

Possible complications

Most complications associated with surgery for a perforated eardrum are uncommon, but may include:

  • an infection, which can cause an increase in pain, bleeding and discharge – contact your GP if you think you may have an infection
  • dizziness that lasts for a few weeks
  • ringing or buzzing in your ear (tinnitus), which may be permanent
  • facial paralysis caused by damage to the nerve that controls the facial muscles – this may get better over time, but some people are left with permanent problems
  • changes in taste – these are usually temporary, but occasionally can be permanent
  • permanent hearing loss, although this is rare

Before you have surgery to repair a perforated eardrum, discuss the potential benefits and risks with your surgeon.

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Frequently asked Questions

Is it safe to fly with a perforated eardrum?

Yes, it is safe to fly with a perforated eardrum. However, if you’ve had surgery to repair a perforated eardrum (myringoplasty), you shouldn’t fly until your doctor or surgeon says it is safe to do so.

What is a perforated eardrum?

If you have a perforated or ruptured eardrum, it means there is a hole or tear in your eardrum. Your eardrum is a thin layer of tissue that separates the outer ear from the middle ear.

A perforated eardrum is usually left to heal by itself, but surgery can sometimes be used to repair it. Read more about treating a perforated eardrum.

Flying with a perforated eardrum

Flying causes changes in air pressure, which can cause discomfort or pain in your ear, as well as temporary hearing loss. This happens particularly when the plane descends, because the pressure inside the aeroplane rises, meaning pressure in the middle ear is lower than that in the cabin.

Air normally passes into or out of your middle ear through a tube connecting it to the back of your nose and throat (eustachian tube). The eustachian tube is closed most of the time and only opens when you yawn or swallow. This tube can become blocked when the pressure in an aeroplane rises.

When you have a perforated eardrum, the air pressure in your middle ear can balance out more easily with the pressure in the surrounding air, because the air is able to pass through the hole. This means that flying with a perforated eardrum may cause less discomfort than flying with eardrums that aren’t perforated.

To find out more about looking after your ears when you fly, see Action on Hearing Loss’s factsheet Flying and the ear (PDF, 257kb).

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 23/04/2015 09:52:05

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