Tympanic perforation: causes and treatments

Tympanic perforation it is a rupture or hole in the membrane that separates the ear canal and middle ear. This membrane is called the eardrum.

The average hatred is connected to the nose by the eustachian tube, whose function is that of balance the pressures in the middle ear .

Tympanic perforation often accompanied by a decrease in hearing , which can scare the patient a lot, and eventually suppuration. These types of injuries can hurt a lot.

However, despite the hearing loss that may occur at the beginning of the injury, most people who suffer a tympanic perforation they end up recovering this sense perfectly .

This is because the tympanic membrane tends to scar By itself. Even patients who have suffered many perforations tend to have an integral eardrum. However, when the membrane regenerates, it does so only with two of the three layers of which it is composed , so the area looks finer.

On the other hand, a patient who has tympanic perforation is more susceptible to infections in that area . Especially when water enters through the external auditory canal. That is why it is recommended to use plugs during the shower and contraindicating the extraction of wax with water.

Tympanic perforation: causes and treatments

Why can a tympanic perforation be caused?

Normally, the main causes of tympanic perforation are due to trauma or infection . The use of cotton swabs or other objects inside the ear canal to clean your ears may be responsible for the breakage.

There are also other causes, which we mention below:

  • Acoustic traumas : Exposure to loud noises such as those associated with explosions can trigger injuries to the eardrum. Fortunately, they are not sounds we hear often in our country.
  • Barotrauma or sudden change of pressure: normally the air pressure in the middle ear and outside are in balance. However, situations can occur, such as traveling by plane, which can cause sudden pressure changes that lead to a tympanic perforation.

Tympanic perforation: causes and treatments 1

  • Cranioencephalic trauma : a blow directly on the ear or a serious injury to the head, as in some traffic accidents, can cause breaks in both the skull and the eardrum.
  • Cotton objects As mentioned above, certain elements, such as cotton swabs or hairpins, can be stuck in the eardrum, injuring it.
  • Ear infections : when the patient presents an infection in the middle or inner ear, it can accumulate pus or other fluid behind the eardrum, causing it to perforate after a while.
  • Blow in the pavilion and / or auditory canal For example, if the patient has suffered a fight and was hit in that area, it can also cause tympanic injury.


The earliest symptom of a perforated eardrum is earache. This pain can be mild to severe. I also know may increase over a period of time or may decrease suddenly, which is the most usual.

Another symptom that may appear is the discharge from the ear. The discharge may be a clear, pus or bloody fluid . In addition, it is possible that the patient, as we have already mentioned, suffers a hearing loss.

On the other hand, t it is also possible the presence of buzzing or ringing in the ears . This symptom is known clinically as tinnitus. Other characteristic symptoms of tympanic perforation are:

  • Dizziness , instability or vertigo,
  • Nausea and vomiting .
  • Weakness in the muscles of the face, although It is usually an uncommon symptom .


As we said at the beginning of the article, the tympanic perforations are usually cured alone . Approximately two weeks must pass before the lesion will heal without the need for treatment.

Despite being cured alone, they usually administer analgesics that do not need a prescription , like NSAIDs, in order to relieve pain.

In the case where the tympanic perforation occurs with infection or in order to prevent it, The doctor may prescribe some type of antibiotic , both in the form of tablets or in eardrops.

Tympanic perforation: causes and treatments 2

Therefore, medical treatment is focused on controlling suppuration. As well you can carry out a surgical treatment when patients have many symptoms or those who are swimmers. This intervention is called tympanoplasty . It involves implanting a small fragment of the body tissue itself to close the perforation of the eardrum.


  • Ioannidis, G., Lazaridis, G., Baka, S., Mpoukovinas, I., Karavasilis, V., Lampaki, S., ... Zarogoulidis, P. (2015, February). Barotrauma and pneumothorax. Journal of Thoracic Disease, 7 (Suppl 1), S38-S43 ncbi.nlm.nih.gov/pmc/articles/PMC4332090/
  • Ruptured eardrum (perforated tympanic membrane). (2014, August 28) my.clevelandclinic.org/services/head-neck/diseases-conditions/hic-ruptured-eardrum-perforated-tympanic-membrane
  • Lou, Z. C., Lou, Z. H., & Zhang, Q. P. (2012). Traumatic tympanic membrane perforations: A study of etiology and factors affecting outcome. American Journal of Otolaryngology - Head and Neck Medicine and Surgery. https://doi.org/10.1016/j.amjoto.2012.01.010
  • Kanemaru, S. I., Umeda, H., Kitani, Y., Nakamura, T., Hirano, S., & Ito, J. (2011). Regenerative treatment for tympanic membrane perforation. Otology and Neurotology. https://doi.org/10.1097/MAO.0b013e31822e0e53

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