Perforated eardrum

Symptoms of a perforated eardrum 

One of the main symptoms of a perforated eardrum is hearing loss. This can vary in severity, depending on the size of the hole. It 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 (before perforation - pain is usually relieved once the ear drum perforates and relieves the build-up of pressure causing pain)
• 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.

Causes of a perforated eardrum 

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

Causes of a hole in the eardrum include:

• a 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

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. This is because they normally heal by themselves in a few weeks or months provided 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. Care must be taken to make sure the flannel is not hot, to avoid scalding or burning of the skin.

Your GP may prescribe antibiotics if:

• your perforated eardrum was caused by an infection
• 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. 

More useful links

• How to use your health service