Ruptured eardrum

Diagnosis

A medical professional, such as your doctor or an ENT specialist, can usually diagnose a ruptured (perforated) eardrum through a visual examination using a lighted instrument like an otoscope or microscope. They might also conduct additional tests to determine the root cause of your ear-related symptoms or to evaluate any hearing loss. These assessments may involve:

• Laboratory examination. If there is discharge from the ear, your doctor may recommend a laboratory test or culture to identify the presence of a bacterial infection in the middle ear.
• Tuning fork evaluation. Tuning forks are metal instruments with two prongs that produce sound upon striking. Your doctor may utilize tuning forks in simple tests to identify hearing loss. A tuning fork assessment can also help determine whether hearing loss stems from damage to the vibrating components of the middle ear, such as the eardrum, damage to the sensors or nerves of the inner ear, or damage to both.
• Tympanometry. A tympanometer employs a device inserted into the ear canal to gauge the eardrum’s reaction to minor shifts in air pressure. Specific response patterns can suggest the presence of a perforated eardrum.
• Audiology exam. These tests comprise a series of evaluations aimed at assessing your hearing abilities across various volumes and frequencies. Typically conducted within a soundproof booth, these tests help determine your hearing thresholds.

Treatment

Most ruptured (perforated) eardrums heal on their own within a few weeks without intervention. Yet, if there are indications of infection, your doctor might recommend antibiotic drops. If the tear or hole in the eardrum doesn’t heal by itself, treatment usually revolves around procedures aimed at closing the perforation. These procedures may entail:

• Eardrum patch. If the tear or hole in the eardrum fails to close naturally, an ENT specialist may opt to seal it using a paper patch or a patch made of alternative materials. During this office-based procedure, your ENT doctor may first apply a chemical to the edges of the tear to promote healing of the eardrum, followed by the application of a patch over the hole. It may be necessary to repeat this procedure multiple times before the hole fully closes.
• Surgery. If patching does not lead to adequate healing or if your ENT doctor concludes that a patch is unlikely to facilitate healing, surgery may be recommended. The most prevalent surgical intervention is known as tympanoplasty. During this procedure, your surgeon grafts a patch of your own tissue to close the hole in the eardrum. Tympanoplasty is typically performed on an outpatient basis, allowing you to return home the same day unless medical circumstances necessitate a longer hospital stay due to anesthesia considerations.