Perforated Eardrum

Signs of a Ruptured Eardrum

Perforated Eardrum

The eardrum is the thin layer of tissue that separates the middle ear, and it plays a crucial role in your hearing. If the eardrum is damaged in some way, you run the risk of hearing loss in that ear.

The inner ear is composed of fragile bones and tissue, so any pain or injuries to the ear should be taken seriously. Even something small like a benign tumor, or cholesteatoma, can result in deafness if you don’t see a doctor fast enough.

Another common issue that our ENT specialists see is a ruptured eardrum, and you’d be surprised at how easily and quickly it can happen. In a second, something can cause your eardrum to tear, and you will undoubtedly feel some pain.

Other signs you may have a ruptured eardrum include:

  • Ear pain that may arise and then subside quickly
  • Mucuslike, pus-filled, or bloody drainage from your ear
  • Sudden hearing loss
  • Ringing in your ear (tinnitus)
  • Dizziness or vertigo
  • Nausea or vomiting caused by vertigo

If you experience any of the above symptoms, you need to contact a doctor and get an ear examination to identify if you have a perforated eardrum. Even if you don’t have a perforated eardrum, these symptoms are not normal and you may be diagnosed with another condition.

What Causes a Ruptured Eardrum?

Due to its delicate structure, there are many reasons an eardrum will develop a tear. This condition can be the result of physical trauma or even just exposure to a loud noise.

The most common causes for a perforated eardrum are:

  • An ear infection/ otitis media
  • Physical trauma to the eardrum, such as a hard punch to your ear or inserting a cotton swab too far into your ear
  • Changes in air pressure, such as while flying or scuba diving
  • A sudden loud noise, such as an explosion or gunfire
  • Attempts to relieve congestion

Some of the above reasons may surprise you, so our ENT specialists explain how the eardrum might rupture in some of these situations.

If you are involved in a fight where someone punches the side of your head, the impact can be so severe that your eardrum ruptures. If this is the case, then you will likely have trouble hearing and maybe experience bleeding from the ear with the injured eardrum. Being in a fight where you get hit this hard increases the chances that you may have other issues, like a concussion.

It’s normal to suffer from sinus congestion and to struggle to find relief, but our doctors urge the public to be careful in the way they try to relieve sinus pressure. You should never plug your nose while you sneeze; sneezing is meant to clear out your sinuses through your nose. If you have pressure built up in your ears and then sneeze while plugging your nose, then the pressure may cause you to blow out your eardrum.

Leaving an ear infection untreated can also result in a perforated eardrum. Signs you may have a middle ear infection include earache, fever, nasal congestion, and trouble hearing. You should never leave an ear infection untreated, as a perforated eardrum can result. This tear in the eardrum can also lead to a worsening infection.

You should try to avoid flying if you have severe sinus congestion, as this can result in your eardrum rupturing during takeoff or landing. If you have to fly, then you should chew gum, wear pressure-managing earplugs, or yawn frequently to help your ears balance out. This can protect you from rupturing your eardrum.

If you work around loud noises, like in construction or the military, make sure to wear proper ear protection at all times. Make sure that your earplugs or earmuffs are industrial-grade, meaning that they aren’t the average product from the store. This can be the difference between protection and permanent hearing loss.

Treating a Ruptured Eardrum

When you visit our office to speak to an ENT doctor in Los Angeles, they will first examine you to be sure that your symptoms are indications of a ruptured eardrum.

In many cases, a ruptured eardrum will heal on its own. However, this doesn’t mean that you shouldn’t receive medical attention. Since a perforated eardrum can lead to more serious issues, you should always get it checked out by a doctor. They can prescribe you antibiotics to prevent or treat an ear infection.

How the Ear Works

The ear has three main parts: the outer ear, the middle ear & the inner ear.

The outer ear, including the external auditory canal, (the part you can see) opens into the ear canal. The eardrum (tympanic membrane) separates the ear canal from the middle ear. The middle ear contains three small bones which help amplify and transfer sound to the inner ear. These three bones, or ossicles, are called the malleus (or hammer), the incus (or anvil), and the stapes (or stirrup). The inner ear contains the cochlea which changes sound into neurological signals and the auditory (hearing) nerve, which takes sound to the brain.Ear Anatomy

Perforated EardrumAny source of sound sends vibrations or sound waves into the air. These funnel through the ear opening, down the external ear canal, and strike your eardrum, causing it to vibrate. The vibrations are passed to the three small bones of the middle ear, which transmit them to the cochlea. The cochlea contains tubes filled with fluid. Inside one of the tubes, tiny hair cells pick up the vibrations and convert them into nerve impulses. These impulses are delivered to the brain via the hearing nerve. The brain interprets the impulses as sound (music, voice, a car horn, etc.).

Hearing & Ear Problems

  • Balance Disorder
  • Central Auditory Processing Disorder
  • Cholesteatoma
  • Chronic Ear Infections
  • Chronic Middle Ear Fluid
  • Dizziness: Lightheadedness & Vertigo
  • Benign paroxysmal positional vertigo (BPPV)
  • Meniere’s Disease/ Endolymphatic hydrops
  • Earaches & Otitis Media
  • Ear wax/ Cerumen/ Glue Ear
  • Eustachian Tube Dysfunction
  • Exostosis/ Surfer’s ear
  • Hearing loss
  • Mastoiditis
  • Otosclerosis
  • Perforated Eardrum
  • Tinnitus
  • Vestibular neuritis/ Labyrinthitis


  • Cerumen (ear wax) removal
  • Otoplasty Ear Correction Plastic Surgery
  • Mastoidectomy
  • Myringotomy with (Ventilating) Tubes
  • Stapedectomy
  • Tinnitus Evaluation and Retraining Therapy
  • Tympanomastoidectomy
  • Tympanoplasty
  • Vestibular Rehabilitation

Outer Ear Infections
Outer ear infections can cause itching in the ear canal, pain and swelling of the ear canal, discharge from the ear, and crusting around the ear canal. Your physician will carefully clean and dry your ear. If your ear is very swollen, the physician may insert a wick soaked with an antibiotic into the ear to get the medicine into the infected area. You may need to put drops in your ear several times a day to keep the wick moist. Oral antibiotics may also be indicated if you have a severe infection, or your physician may suggest a cream or ointment medicine for some types of infection.

Middle Ear Infections
A middle ear infection is an infection of the air-filled space in the ear behind the eardrum. Ear infections usually begin with a viral infection of the nose and throat. Ear infections may also occur when you have allergies. Symptoms of a middle ear infection include earache, hearing loss, feeling of blockage in the ear, fever, and dizziness. The physician will check for fluid behind the eardrum, and a hearing test may also be recommended if you are experiencing hearing loss. Antibiotic medicine is a common treatment for ear infections. However, recent studies have shown that the symptoms of ear infections often go away in a couple of days without antibiotics. Your provider may recommend a decongestant (tablets or a nasal spray) to help clear the eustachian tube.

Benign Paroxysmal Positional Vertigo
Benign Proxysmal Positional Vertigo is one of the most common causes of vertigo in adults. It presents with the illusion of movement, which occurs within a few seconds of a change in head positioning. Most commonly a short sensation of spinning is experienced after lying down in bed, arising in the morning, or rolling over in bed at night, but may also occur when one looks up to a high shelf, or down under furniture. Typically, the symptoms last seconds to minutes or so before resolving. BPPV is due to microscopic crystals, or otoconia, floating around in one of the compartments of the inner ear. The movement of these particles stimulate the sensory endings of the vestibular (balance) nerve, producing vertigo.

The good news is that BPPV responds well to physical therapy maneuvers. Medications rarely help. A trained physician or vestibular therapist can perform therapy which can rapidly eliminate the symptoms of dizziness. These maneuvers are designed to relocate the crystals to a part of the inner ear where they will not produce any symptoms. Treatments for BPPV can usually be performed in one or two sessions with very high success rates. This office frequently diagnosis and properly treats this disorder.

Meniere’s Disease
Meniere’s Disease is a problem in the inner ear. It can cause severe dizziness (vertigo) and hearing loss. It usually affects just one ear, but it can happen in both ears. There can be a significant hearing loss, but complete deafness is rare. The symptoms can be mild or severe. Although the dizziness can be very disabling, it can usually be controlled.

Excessive amounts of earwax, or cerumen, can block the ear canal and cause temporary hearing impairment. Earwax should be removed only by a professional. Q-tips, ear candeling, or other methods of home earwax removal are not recommended. Please consult your physician if you suspect earwax impaction.

Labyrinthitis & Vestibular Neuritis
Labyrinthitis is an inflammation of the inner ear. Vestibular neuritis is an inflammation of the nerves connecting the inner ear to the brain. In vestibular neuritis, a virus similar to the herpes virus causes an infection. This infection causes swelling and inflammation of the vestibular nerves or the labyrinth. Sometimes bacteria from a middle ear infection cause labyrinthitis. Symptoms of vestibular neuritis and labyrinthitis include dizziness or vertigo, trouble maintaining balance, and nausea. Diagnosis may include a hearing evaluation, balance testing, an MRI scan, and possible blood testing.

Otosclerosis is the abnormal growth of bone in the middle ear which can cause conductive hearing loss, or the prevention of the normal transmission of sound. It is most common for otosclerosis to affect one of the bones in the middle ear called the stapes. Other symptoms of otoscerlosis may include ringing in the ears and dizziness. Otosclerosis can be diagnosed by your ENT physician, and will include a hearing evaluation by an audiologist. Treatment may consist of a surgery called a stapedectomy, where a prosthetic device replaces the abnormal bone growth.

Tinnitus (ringing in the ears)
Tinnitus (ringing in the ears) is not normal, and can be a symptom of other disorders. Some of the causes of tinnitus are hearing loss, noise exposure, ear infections, sinus infections, Meniere’s disease, ear or head injury, otosclerosis, cardiovascular disease, certain medications, anxiety or stress, heavy smoking, and thyroid disorders. Tinnitus can be described as ringing, buzzing, crickets, escaping air, and many other types of sound. Your physician will ask about your symptoms and may order a hearing test, scans, or blood work to determine the possible cause. Treatment options may include a hearing aid or masking device, Tinnitus Retraining Therapy (TRT), and perhaps certain medication.

Hearing Loss
Types of hearing loss: Hearing loss is categorized by what part of the auditory system is damaged. These fall into three categories: Conductive hearing loss, sensorineural hearing loss, or mixed hearing loss.

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