9 Signs You Might Have a Burst or Perforated Eardrum

Anatomy diagram of human ear with eardrum perforation from cotton bud

Table of Contents

The nine signs you may have a perforated eardrum include:

  1. Hearing loss
  2. A spinning sensation (vertigo)
  3. Nausea or vomiting from vertigo
  4. Ear pain that may subside
  5. Mucus-like, pus-filled, or bloody drainage from your ear
  6. A ringing in your ear (tinnitus)
  7. Episodic ear infections
  8. Facial weakness
  9. Dizziness

The extent of hearing loss you might experience will depend on the hole’s size in your eardrum.

Let your doctor know if you experience these signs and symptoms of a perforated eardrum. It’s essential to seek treatment right away.

Keep reading to learn more about what happens when you have a perforated eardrum. This article will review the symptoms, potential causes, and treatments involved.

Understanding these potential causes and symptoms could ensure you receive the help you need for treatment.

What is a Perforated Eardrum?

The eardrum or tympanic membrane is the thin tissue that separates your middle ear and the ear canal. A tear in this tissue is called: 

  • perforated eardrum
  • tympanic membrane perforation
  • burst eardrum

When your eardrum is ruptured, you can experience hearing loss. It can take a few weeks for your eardrum to heal without treatment. Otherwise, you might need a tympanoplasty or myringoplasty.

A myringoplasty is sometimes done intentionally to relieve pressure, such as fluid buildup in the middle ear. The procedure repairs a small eardrum perforation using a paper-like material or gel foam. 

A tympanoplasty is a surgical reconstruction of a more extensive eardrum perforation and may involve scar tissue repair and a small skin graft to help repair the eardrum.

Tympanoplasty procedure diagram for a burst or perforated eardurm

How Is a Perforated Eardrum Investigated?

Your Ear Health practitioner, general practitioner or otolaryngologist (ear, nose and throat specialist) can complete a visual exam to determine if you have a ruptured eardrum.

They might need additional tests to determine if you’re experiencing hearing loss. Tests can include:

  1. Audiology exam to measure how well you hear sounds at different pitches and volumes.
  2. Tympanometry involves inserting a device into the ear canal to measure the eardrum’s response to air pressure changes.
  3. Tuning fork evaluation reveals hearing loss due to damage in the middle ear, sensors or nerves of the inner ear, or both.
  4. Pathology tests to help determine the makeup of any discharge from your ear.

Before your appointment:

  • Keep track of any symptoms you experience.
  • Let your doctor know if your family has a history of ear infections.
  • Note any recent air travel, head, or ear injuries, too.

What Causes a Ruptured Eardrum?

A study from 2018 identified the primary reasons for traumatic eardrum tears (TMPs) in the United States. The study examined 949 visits to the emergency department. The primary reason for TMPs was foreign body instrumentation, notably cotton-tipped applicators.

The study found that TMPs are most common in children 18 years or younger, with foreign body instrumentation being the leading cause, accounting for 60.6% of cases. Cotton-tipped applicators alone are responsible for 45.3% of these injuries.

Other significant causes include water trauma, which is the most frequent cause among teenagers and young adults aged 13 to 18, as well as strikes to the head, blast injuries, and falls.

An ear infection can lead to a condition known as otitis media, a disease of the middle ear. This part of the ear is located just behind the eardrum. Ear infections are caused by bacteria or viruses that enter the middle ear and cause inflammation and fluid buildup. This fluid buildup can increase pressure on the eardrum, leading to pain and, in severe cases, eardrum rupture.

Ear barotrauma can cause a burst eardrum. Ear barotrauma refers to the stress exerted on the eardrum and other middle ear structures due to a significant difference in air pressure between the inside and outside of the ear. This condition is most commonly experienced during rapid altitude changes, such as takeoff and landing on aeroplane flights, scuba diving, driving in the mountains, or even in fast-moving elevators.

A young woman using a cotton bud in her ear, a common cause of eardrum perforation.
A young woman using a cotton bud in her ear, a common cause of eardrum perforation.

What Are the Complications of a Perforated Eardrum?

Your eardrum has two primary responsibilities: hearing and protection.

When sound waves strike your eardrum, the eardrum vibrates. It’s then able to translate sound waves into nerve impulses.

Your eardrum also acts as a barrier, protecting your middle ear from foreign substances.

If you have a burst eardrum, your eardrum might not function properly. For example, you could develop conductive hearing loss. Middle ear infections are common, too.

Remember, the eardrum protects the middle ear from bacteria. If your ruptured eardrum fails to heal, it will be vulnerable to infection. 

Developing a middle ear cyst is a potential complication as well. Though it’s rare, a cyst could form in the middle ear.

Risk Factors of a Perforated Eardrum

Your chances of developing a ruptured eardrum can increase if you:

  • sustain injury to the ear
  • insert objects in your ear
  • scuba dive regularly
  • fly regularly
  • have a history of eardrum ruptures
  • have a history of ear surgery (such as grommets).

You can discuss ways to safeguard yourself from a potential burst eardrum with your healthcare practitioner.

How Do You Prevent a Burst Eardrum?

There are a few ways you can protect yourself from an eardrum injury or burst eardrum.

First, treat any middle ear infections you experience right away. Possible symptoms include:

  • Reduced hearing
  • Fever
  • Earache
  • Nasal congestion

Let your doctor know if you experience these symptoms. You can seek treatment to protect against additional damage to your eardrum.

The next time you plan on flying in an aeroplane, protect your ears. Use pressure-equalising earplugs, chew gum, or yawn to avoid pressure changes. You should avoid flying with blocked ears or cold or flu-like symptoms.

Make sure to keep your ears free of foreign objects. Avoid digging hardened ear wax out with a paperclip or cotton swab. Otherwise, you could risk tearing your eardrum.

If you plan on attending an event where noise is an issue, protect your ears with earplugs.

Possible Therapies and Treatment

Tympanic membrane perforation has a spontaneous healing rate between 78 and 90%. If it fails to heal after six months, you could experience conductive hearing loss. Instead of waiting to heal independently, visit a healthcare practitioner immediately.

A general practitioner might prescribe antibiotic drops if you have a bacterial infection. If you’re in pain, they may recommend over-the-counter medication for relief.

A myringoplasty procedure might be suggested to close the tear. If the myringoplasty wasn’t successful, your doctor might recommend surgery.

The most common surgical procedure for a perforated eardrum is called tympanoplasty.

A surgeon will graft a patch of your tissue to close the tear in your eardrum. You can go home the same day unless anesthesia requires a more extended hospital stay.

Larger perforations and tears at the edges of your eardrum may require surgery. If an ear infection caused your eardrum perforation, surgery could also help.

5 Effective Home Care Strategies

Experiencing an eardrum perforation can be an uncomfortable and distressing situation. While medical advice is paramount, several home care strategies can aid in the healing process and provide comfort. Here’s a guide to managing an eardrum perforation at home.

1. Gentle Pain Relief with Warm Compresses

A warm, dry compress is one of the simplest yet effective ways to alleviate discomfort. This can be done by taking a clean cloth, warming it (ensuring it’s not too hot), and gently placing it over the affected ear. Repeat this throughout the day as needed. The warmth not only provides a soothing effect but can also help in reducing pain and inflammation.

2. Minimising Pressure in the Ears

A key aspect of care involves carefully managing pressure within the ears. This is crucial since increased pressure can potentially hinder the healing of the perforated eardrum. It’s advisable to blow your nose gently and infrequently to avoid this. Forceful blowing can create undue pressure in the ears, leading to discomfort and possibly prolonging the healing process.

3. Protecting the Ear During Water Exposure

Water can be a significant hindrance to the healing of an eardrum perforation. Hence, it’s essential to keep the ear as dry as possible. While your eardrum is healing, avoid activities like swimming or diving. Consider using earplugs or a shower cap to prevent water from entering the ear canal during showers or baths. This precaution helps in reducing the risk of infections and further complications.

4. Keeping the Ear Canal Dry

Ensuring that the ear canal remains dry is crucial. Moisture in the ear canal can create an environment conducive to infections, complicating the healing process. If you notice ongoing dampness, a follow-up visit to an Ear Health clinic for ear canal microsuction might be necessary. This procedure removes unwanted moisture and keeps the ear canal dry, aiding healing.

5. Caution with Ear Drops

While various ear drops are available over the counter, using them cautiously is essential. Do not apply drops to the affected ear unless expressly advised by a healthcare professional. Unsuitable ear drops or incorrect usage can aggravate the situation, leading to further complications.


Dealing with an eardrum perforation requires a careful approach that balances medical advice with practical home care measures. By following these strategies, you can effectively manage the condition and support the healing process. Remember, while these tips are helpful, they should complement, not replace, professional medical advice. If you have concerns or the condition worsens, it’s always best to consult your healthcare provider.

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