Eardrum perforation

anatomy of the ear

A perforation, or rupture, of the eardrum — the thin membrane (tympanic membrane) that separates the middle ear from the ear canal — is not uncommon.

Causes of eardrum perforation

Eardrum perforation can occur following an infection in the middle ear, when pus accumulates and causes the pressure in the middle ear to increase until the drum ruptures. Once the drum has ruptured, the pus can drain into the ear canal.

The original infection (and pressure increase) is usually accompanied by symptoms such as pain and fever, with discharge from the ear following the rupture. Antibiotics will usually be required if the perforation is associated with an infection.

Other causes of a perforated eardrum include a hard blow to the ear; rapid changes in pressures, such as associated with diving or flying; injury from an object being inserted in the ear; or exposure to a sudden loud noise, such as an explosion.

Symptoms of a perforated eardrum

A perforated eardrum is usually painful initially, and is often accompanied by decreased hearing and occasional discharge.


You are advised to avoid getting water in your ear if you have a perforated eardrum, as it can be harmful to the middle ear. Wear an earplug in the shower or bath, and while swimming. It is best to avoid underwater swimming and diving until the perforation heals.

Most perforated eardrums will heal spontaneously within a few weeks, but this should be checked by your doctor. If healing does not occur, the perforation may need to be patched surgically in a procedure known as a myringoplasty.

Occasionally, a perforated eardrum will be associated with a significant underlying disease, such as a chronic infection or a cholesteatoma. A cholesteatoma is a skin cyst that, as it grows, can destroy bone and lead to significant complications. Underlying disease may be suspected if your ear is persistently discharging, and requires treatment by a specialist in most cases.

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