Perforated Eardrum (Tympanic Membrane Perforation)
When the eardrum has a hole or tear, which may cause pain, discharge, or temporary hearing changes
Medically reviewed by a board-certified ENT specialist
- Author:
- Dr. Poj Pinyopornpanish — Otolaryngologist · Thai Board of Otolaryngology
- Medical reviewer:
- Dr. Poj Pinyopornpanish — Otolaryngologist · Thai Board of Otolaryngology
- Reviewed on:
- Last updated:
- Estimated reading time: 4 min
Overview
What is a perforated eardrum?
A perforated eardrum (tympanic membrane perforation) means the thin membrane separating the outer and middle ear has a hole or tear. Common causes include middle ear infection, injury from objects or trauma, or pressure-related events. Symptoms may include ear pain, discharge, or temporary hearing reduction. Small perforations often heal on their own over weeks to months, while larger or persistent holes may need monitoring or further treatment. Clinical assessment helps determine size, cause, and impact on hearing.
Symptoms
Common symptoms
Symptoms depend on perforation size, cause, and whether infection is present.
Ear pain (especially when the perforation first occurs)
Discharge or fluid from the ear
Reduced or muffled hearing in the affected ear
A feeling of fullness in the ear
Ringing in the ear (tinnitus)
Dizziness (less common)
Signs of infection such as fever or persistent ear pain (in some cases)
Causes
What causes a perforated eardrum?
Perforations may result from infection, injury, or pressure changes.
Middle ear infection
Infection or fluid pressure in the middle ear may cause the eardrum to rupture and drain.
Mechanical injury
Objects in the ear, direct trauma, or accidents can tear the eardrum.
Pressure changes
Rapid pressure shifts from flying or diving may injure the eardrum in some situations.
Loud noise
Very intense noise exposure can occasionally cause eardrum injury.
Ear surgery or procedures
Some cases relate to prior ear surgery or ventilation tube placement.
Other factors
Chronic conditions or repeated infections may weaken the eardrum over time.
When to seek care
When should I see an ENT specialist?
Seek assessment if you suspect perforation, have discharge, or notice hearing changes.
Discharge or bleeding from the ear
Clear or persistent hearing reduction
Severe or worsening ear pain
Fever or concerning infection symptoms
Symptoms after injury or ear infection
Dizziness or balance problems
A perforation that does not heal as expected
Need for hearing assessment or treatment planning
Diagnosis
How is it diagnosed?
Your doctor will ask about symptoms, injury, infection history, and hearing changes. The ear is examined with an otoscope to assess perforation size and position, discharge, and signs of infection. Hearing tests (audiometry) or eardrum function tests (tympanometry) may be used to evaluate hearing impact and healing. Follow-up visits help determine whether the hole is closing or further treatment is needed.
Treatment
Treatment options
Treatment depends on perforation size, cause, duration, and hearing impact.
Observation and infection prevention
Small holes often heal spontaneously. Keeping the ear dry and avoiding water exposure may be advised while monitoring progress.
Ear drops or oral medication
If infection or inflammation is present, medication may be prescribed and should be used exactly as directed.
Water protection
Ear plugs or other protection may be recommended for bathing or swimming.
Eardrum repair surgery
If the perforation does not heal or affects hearing, tympanoplasty may be considered when appropriate.
Self-care
What you can do at home
Focus on preventing infection and avoiding further injury.
Do not insert objects into the ear canal
Keep water out of the ear as advised
Avoid forceful nose blowing and unprescribed ear drops
Avoid flying or diving if your doctor recommends postponement
Monitor discharge, pain, and hearing changes
Attend follow-up to assess healing
Prevention
Reducing the risk of perforation
Not all perforations can be prevented, but certain steps may help.
Avoid cotton buds and objects in the ear canal
Treat ear infections promptly to reduce rupture risk
Protect the ears from trauma and very loud noise
Be cautious with pressure changes when flying or diving if you have ear problems
Seek assessment for concerning ear symptoms rather than delaying care
FAQ
Frequently asked questions
Common questions about perforated eardrums, healing, and care.
Will a perforated eardrum heal on its own?
Many small perforations heal within weeks to months. Larger or chronic holes may not close without monitoring or treatment.
Can a perforated eardrum cause permanent hearing loss?
Hearing may be temporarily or permanently affected depending on perforation size, duration, and whether other middle ear problems are present. Hearing tests help assess this.
Can I swim with a perforated eardrum?
Water should generally be kept out of the ear until your doctor advises otherwise. Protective measures may be recommended.
Is surgery always needed?
No. Many perforations heal without surgery. Repair may be considered when healing does not occur, infections recur, or hearing is significantly affected.
Are ear drops safe?
Only when prescribed and appropriate for your ear condition. Unprescribed drops should be avoided, especially if eardrum status is uncertain.
References
Related guidelines and patient resources
The sources below are recognized international guidelines and patient-education resources for general learning. They are not individualized medical advice.
Patient information on ear and hearing conditions
AAO-HNS / ENThealth
View source (AAO-HNS / ENThealth)Patient education and clinical guidance in otolaryngology
American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS)
View source (American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS))Public ENT health information
ENThealth (AAO-HNS Foundation)
View source (ENThealth (AAO-HNS Foundation))
Educational information
Medical Disclaimer
This information is intended for educational purposes only and does not replace diagnosis or treatment by a qualified physician. If you have concerning symptoms, please consult an ENT specialist.
Related links
Learn more
Related clinic pages to help you explore conditions, services, and procedures.
Ear discharge or hearing changes?
An assessment can determine whether the eardrum is perforated and guide monitoring or treatment.