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The eardrum is essential for hearing because it senses sound waves and conveys the vibrations to the brain, but it also works as a shield to seal the inner ear and keep it free from infection. Whenever your eardrum is intact, your inner ear is basically a sterile and safe place; but when it is punctured or torn, harmful bacteria can get in and spark a major infection known as otitis media.

A ruptured eardrum (in medical language, a tympanic membrane perforation) is what occurs when this essential membrane is damaged by punctures or tears. A ruptured eardrum can occur from many causes, the most common being an ear infection, which causes fluid to push against the eardrum membrane and finally cause it to tear. A further common cause of punctured eardrums are foreign objects introduced into the ears. For instance, it is possible to puncture your own eardrum with a cotton swab. Barotrauma is yet another possible cause of a punctured ear drum. When the pressure outside the ear is very different than the pressure inside the ear – higher or lower – the ear drum might not be able to withstand the pressure difference and rips. Flying and scuba diving are a couple of situations in which this is more likely to happen. Sudden loud noises and explosions may also cause ruptured ear drums. This is known as acoustic trauma.

Indications of punctured eardrums include pain in the ear, hearing difficulties in the affected ear, dizziness or vertigo, and fluid draining from the ear. A ruptured ear drum should be evaluated and treated by a specialist. Timely attention is important to avoid infection and hearing damage. If left untreated, you risk severe inner and middle ear infections, middle ear cysts and the possibility of long term loss of hearing.

Specialists diagnose this condition using an otoscope, which is a tool with an internal light that enables them to see the eardrum. Punctured eardrums generally heal by themselves in 2 to 3 months. During this time period, the doctor will probably advise you to avoid swimming and diving and to avoid blowing your nose as much as possible. It’s also advisable to avoid any extraneous medications. For tears along the edges of the eardrum, the doctor might want to insert a temporary dam or patch which helps reduce the risk of infection. In rare cases, surgery may be recommended.

Any remaining discomfort can be managed by using over-the-counter pain medications such as ibuprofen or acetaminophen. The most important safety measures you can adopt to avoid ruptured eardums are to 1) avoid placing any objects into your ears, even to clean them, and 2) address ear infections promptly by visiting a specialist.