Eardrums are important, serving two vitally important roles in hearing. First and foremost they vibrate in response to sound. Second they create a barrier that safeguards the inner ear from infection. While undamaged, the eardrum seals off the inner ear setting up a sterile environment. Once the ear drum is punctured or torn, the inner ear is left susceptible to infection.

A perforated or ruptured eardrum (in medical language, a tympanic membrane perforation) is what happens when this essential membrane is damaged by punctures or tears. There are many ways that an eardrum may become perforated, the most common of which is as a result of an ear infection where the buildup of fluid pushes against the eardrum until it rips. Many people puncture their own eardrums by inserting foreign objects into the ears, such as the use of Q-tips to take out ear wax. Another well-known root cause is barotrauma – the situation that occurs when the barometric pressure outside the ear is different from the pressure inside the ear – which can happen on airplane flights or in scuba. Eardrums can also become ruptured due to acoustic trauma or head injuries such as explosions.

Indications of ruptured eardrums include pain in the ear (including persistent pain that stops suddenly), hearing loss in the affected ear, dizziness or vertigo, and fluid draining from the ear. If you encounter any of these signs and symptoms, see a specialist, because if the eardrum is punctured, timely and correct treatment is essential to prevent infection and hearing damage. If left untreated, you risk severe inner and middle ear infections, middle ear cysts and the possibility of permanent loss of hearing.

Doctors assess this condition using an otoscope, which is a tool with an internal light which enables them to see the eardrum. Punctured eardrums typically heal on their own in 2-3 months. During this time period, your healthcare provider will probably advise you to avoid diving and swimming and to refrain from blowing your nose as much as possible. It’s also advisable to avoid any non-essential medications. For holes along the edges of the eardrum, the doctor may choose to insert a temporary dam or patch which helps guard against infection. In very rare cases, surgery may be suggested.

Your specialist may also recommend over-the-counter pain medications such as acetaminophen or aspirin to deal with pain. The key safety measures you can adopt to avoid this condition are to 1) refrain from inserting any objects into your ear canal, even to clean them, and 2) address ear infections promptly by visiting a doctor.