Ruptured eardrum (perforated eardrum)

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Causes

By Mayo Clinic staff

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Illustration showing inner ear, middle ear and outer ear How your ear works
Illustration of eardrum, showing rupture Ruptured eardrum

Your eardrum (tympanic membrane) has two primary roles:

  • Hearing. When sound waves strike it, your eardrum vibrates — the first step by which structures of your middle and inner ears translate sound waves into nerve impulses.
  • Protection. Your eardrum also acts as a barrier protecting your middle ear from water, bacteria and other foreign substances.

Causes of a ruptured, or perforated, eardrum may include:

  • Middle ear infection (otitis media). A middle ear infection often results in the accumulation of fluids in your middle ear. Pressure from these fluids can cause the eardrum to rupture.
  • Barotrauma. Barotrauma is stress exerted on your eardrum when the air pressure in your middle ear and the air pressure in the environment are out of balance. If the pressure is severe, your eardrum can rupture. Barotrauma is also called airplane ear, because it's most often caused by air pressure changes associated with air travel. Other events that can cause sudden changes in pressure — and possibly a ruptured eardrum — include scuba diving and a direct blow to the ear, such as the impact of an automobile air bag.
  • Loud sounds or blasts (acoustic trauma). A loud sound or blast, as from an explosion or gunshot - essentially an overpowering sound wave — can cause a tear in your eardrum.
  • Foreign objects in your ear. Small objects such as a cotton swab or bobby pin can puncture or tear the eardrum.
  • Severe head trauma. Severe injury, such as skull fracture, may cause the dislocation or damage to inner ear structures, including your eardrum.
Complications Symptoms
References
  1. Perforated eardrum. American Academy of Otolaryngology - Head and Neck Surgery. http://www.entnet.org/HealthInformation/perforatedEardrum.cfm. Accessed Nov. 16, 2010.
  2. Evans AK, et al. Evaluation and management of middle ear trauma. http://www.uptodate.com/home/index.html. Accessed Nov. 16, 2010.
  3. Lustig LR, et al. Ear, nose and throat disorders. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment. 50th ed. New York, N.Y.: The McGraw-Hill Companies. 2011. http://www.accessmedicine.com/content.aspx?aID=2436&searchStr=tympanic+membrane+perforation. Accessed Nov. 16, 2010.
  4. Vernick DM, et al. Ear barotrauma. http://www.uptodate.com/home/index.html. Accessed Nov. 16, 2010.
  5. Limb CJ, et al. Acute otitis media in adults (suppurative and serous). http://www.uptodate.com/home/index.html. Accessed Nov. 16, 2010.
  6. Cholesteatoma. American Academy of Otolaryngology - Head and Neck Surgery. http://www.entnet.org/HealthInformation/cholesteatoma.cfm. Accessed Nov. 22, 2010.
  7. Yates PD, et al. Otitis media. In: Lalwani AK. Current Diagnosis and Treatment in Otolaryngology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies. 2008. http://www.accessmedicine.com/content.aspx?aID=2830509. Accessed Nov. 23, 2010.
  8. Shelby JH (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 28, 2010.
DS00499 Feb. 4, 2011

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