Ruptured eardrum: Causes, Symptoms, Treatment, and Cost

Tympanic membrane perforation, commonly known as the ruptured eardrum or perforated eardrum, describes a tear or hole in the thin membrane separating the middle ear from the outer ear.

There are two types of ruptured eardrum:

• Traumatic rupture: This happens as a result of an abrupt ear trauma or damage, such as a blow to the ear or an unexpectedly loud noise.
• Spontaneous rupture: This occurs without any apparent cause and is usually due to an infection or a sudden change in pressure, such as during air travel or scuba diving.

The most typical reasons for an eardrum rupture are:

• Infections in the middle ear
• A head injury or an unusually loud noise might cause ear damage.
• Inserting items like cotton swabs or hairpins within the ear
• Air pressure fluctuations, such as those that happen during scuba diving or flying, are often exposed to loud noises.

A ruptured eardrum may cause these symptoms:

• Ear pain: An eardrum rupture may cause pain in the ear. Mild to severe discomfort may be experienced, and it may come and go.
• Hearing loss: Hearing loss might occur in the ear that has experienced eardrum rupture. This might be either temporary or permanent, depending on the severity of the injury.
• Tinnitus: A ruptured eardrum may cause a ringing or buzzing noise to be heard in the ear.
• Vertigo: Dizziness or a sensation of spinning may occur with a ruptured eardrum.
• Drainage from the ear: A ruptured eardrum can cause fluid to leak from the ear, which may be clear or bloody.
• Nausea or vomiting: In some cases, a ruptured eardrum can cause nausea or vomiting.

Some ways to prevent a ruptured eardrum include:

• Protect your ears: Wear earplugs or protective earmuffs in noisy environments, such as when using power tools or attending loud concerts.
• Avoid inserting objects in the ear: Avoid placing cotton swabs or other things in the ear canal since doing so might harm the eardrum.
• Treat ear infections promptly: Seek medical treatment for ear infections, as untreated infections can lead to a ruptured eardrum.
• Avoid exposure to sudden changes in air pressure: Try to equalise the pressure in your ears when flying or scuba diving, as sudden changes in pressure can cause a ruptured eardrum.
• Treat allergies and respiratory infections: Manage allergies and respiratory infections promptly to reduce the risk of a ruptured eardrum.
• Avoid head trauma: Protect your head from injury, as head trauma can cause a ruptured eardrum.

Several diagnostic tests can be used to confirm a ruptured eardrum, including:

• Otoscope exam: An otoscope is a device that allows a doctor to examine the ear canal and eardrum. The doctor may be able to observe a rip or hole in the eardrum if the eardrum has burst.
• Tympanometry: A test called tympanometry measures how the eardrum reacts to changes in air pressure. A ruptured eardrum may show a different pattern of movement compared to a healthy eardrum.
• Audiometry: A hearing test called audiometry is used to gauge a person's capacity for hearing various tones and pitches. A ruptured eardrum can cause temporary or permanent hearing loss, which can be detected with an audiometry test.
• CT scan or MRI: In some cases, a CT scan or MRI may be used to get a more detailed view of the ear and to rule out other conditions that may be causing symptoms.

Ruptured eardrum problems might include:

• Pain and discomfort: The ear may hurt and feel uncomfortable if the eardrum is burst. Whether the pain is slight or strong, it may become worse with movement or pressure.
• Hearing loss: Hearing loss that is either temporary or permanent may result from an eardrum rupture. This is true because the eardrum serves as a conduit for sound waves that go to the inner ear.
• Infection: The middle ear is susceptible to bacterial and viral infection when the eardrum is ruptured. Otitis media, an infection, may result from this.
• Tinnitus: A ringing, buzzing, or humming noise in the ear that is not brought on by an external source is referred to as tinnitus. It could be brought on by an eardrum rupture.
• Vertigo: Vertigo is a spinning or lightheaded feeling. As the inner ear regulates balance, a ruptured eardrum might be the cause.
• Cholesteatoma: A cholesteatoma is the growth of skin cells in the middle ear. It may come from an eardrum rupture and cause infection as well as hearing loss.
• Facial nerve paralysis: The facial nerve runs through the middle ear and can be damaged as a result of a ruptured eardrum. This can lead to facial nerve paralysis, which can cause drooping of the face and difficulty with facial expressions.
• Meningitis: In rare cases, a ruptured eardrum can lead to meningitis, which is a serious infection of the brain and spinal cord. Symptoms include fever, headache, and neck stiffness.

The following are some natural cures that could be useful:

• Garlic oil: Antimicrobial and anti-inflammatory properties of garlic may aid to lessen inflammation and encourage healing. Crush a few garlic cloves and boil them in sesame oil or coconut oil, strain the oil, and let it cool. Put a few drops of the oil in the affected ear twice a day.
• Holy basil oil: Holy basil, also known as tulsi, has antibacterial and anti-inflammatory properties that may help reduce inflammation and promote healing. Mix a few drops of holy basil oil with coconut oil or sesame oil and put a few drops of the mixture in the affected ear twice a day.
• Turmeric: Due to the anti-inflammatory and antibacterial effects of turmeric, several conditions may be improved. Mix a teaspoon of turmeric powder with a little warm water to make a paste. Apply the paste to the area surrounding the ear, let it dry, and then remove it with warm water.
• Neem oil: Neem's antibacterial and anti-inflammatory qualities may aid to lessen inflammation and stop infection. Mix a few drops of neem oil with coconut oil or sesame oil and put a few drops of the mixture in the affected ear twice a day.
• Warm compress: The discomfort and swelling in the afflicted ear may be lessened by applying a warm compress to it. Place a clean towel over the troublesome ear for ten to fifteen minutes after dipping it in warm water and wringing away the excess.

Here are some food suggestions that might be beneficial:

• Anti-inflammatory foods: Consuming foods high in anti-inflammatory vitamins and minerals, such as omega-3 fatty acids, vitamin C, and antioxidants, may aid to decrease inflammation and encourage healing. Fatty fish, leafy greens, berries, nuts, and seeds are a few examples.
• Protein: Eating protein-rich foods, such as lean meats, fish, beans, and legumes, can help support the body's healing processes.
• Vitamin A: The health of the mucous membranes, particularly those in the ear, depends on vitamin A. Ear health may be supported by consuming vitamin A-rich foods such as sweet potatoes, carrots, leafy greens, and liver.
• Zinc: The immune system needs zinc to operate properly, and it may also lower the risk of infection. Eating foods that are rich in zinc, such as oysters, beef, pumpkin seeds, and lentils, may help support overall health.
• Hydration: Being hydrated is crucial for general health and might aid in the healing process. Drink a lot of water and other hydrating beverages, such as herbal tea and coconut water.

These are some foods to avoid if you have a ruptured eardrum:

• Spicy foods – Spicy foods can irritate the throat and nose, leading to increased pressure in the middle ear, which can be dangerous for a ruptured eardrum.
• Acidic foods – Acidic foods such as citrus fruits or juices can increase the acidity in the stomach, which can cause reflux and lead to more pain and pressure in the ear.
• Dairy products – Milk, cheese, and yogurt are dairy items that might boost the body's production of mucus, which can cause increased ear congestion.
• Sugar – Consuming sugar can suppress the immune system and increase inflammation in the body, making it harder for the body to fight off any infection that may be present in the ear.
• Alcohol – Alcohol can cause dehydration, which can worsen any existing inflammation in the ear and can also interfere with the medications prescribed for the condition.

A ruptured eardrum may be treated surgically using a variety of techniques, including:

• Tympanoplasty: This procedure involves repairing the hole in the eardrum by grafting tissue onto it.
• Myringotomy: A surgical incision is made in the eardrum to drain the fluid or pus that has accumulated behind it. This is done to relieve pressure and promote healing. A small tube may be inserted into the hole to keep it open for a few months, allowing the eardrum to heal.
• Mastoidectomy: In certain instances, an infection in the middle ear that has migrated to the mastoid bone behind the ear may be the reason for a burst eardrum. Surgery may be required in these circumstances to remove the infected tissue and restore the eardrum.
• Ossiculoplasty: This is a procedure to repair or replace the small bones in the middle ear (the ossicles) that have been damaged or lost due to infection or trauma. This surgery can improve hearing in patients with severe damage to the middle ear.

See an ENT expert, also known as an otolaryngologist, if you believe you may have a burst eardrum. ENT experts are qualified to identify and manage diseases of the nose, throat, and ears, including ruptured eardrums.

Here are some classes of medications that may be used to treat a ruptured eardrum:

• Antibiotics: If a ruptured eardrum is caused by an infection, antibiotics may be prescribed to treat the infection and prevent further complications. Examples of antibiotics that may be used include amoxicillin, azithromycin, and ciprofloxacin.
• Ear drops: It is possible to be administered ear drops to aid with infection prevention, pain relief, and inflammation reduction. Antibiotics, steroids, or a mix of the two may be included in ear drops. Examples of ear drops that may be used include neomycin and polymyxin B sulphate and hydrocortisone ear drops.
• Pain relievers: It is possible to be administered ear drops to aid with infection prevention, pain relief, and inflammation reduction. Antibiotics, steroids, or a mix of the two may be included in ear drops. In some cases, prescription-strength pain relievers may be necessary.
• Decongestants: If a ruptured eardrum is caused by congestion, decongestants may be recommended to help reduce swelling and promote drainage. Examples of decongestants that may be used include pseudoephedrine and phenylephrine.
• Antihistamines: If a ruptured eardrum is caused by allergies, antihistamines may be recommended to help reduce inflammation and relieve symptoms. Examples of antihistamines that may be used include loratadine and cetirizine.

An eardrum that has ruptured might heal over time, depending on the extent of the injury. Usually, the eardrum will heal on its own in a matter of weeks to months. However, if the injury is severe or there are complications, it may take longer for the eardrum to heal.

The results of surgery for a ruptured eardrum can vary, but in many cases, the repair is considered permanent. However, it's important to follow post-operative care instructions and avoid activities that could damage the repaired eardrum, such as diving or flying. If the underlying cause of the rupture is not addressed or if a new injury occurs, a new tear or rupture could develop.

Here are some classes of medications that may be used to treat a ruptured eardrum:

• Antibiotics: If a ruptured eardrum is caused by an infection, antibiotics may be prescribed to treat the infection and prevent further complications. Examples of antibiotics that may be used include amoxicillin, azithromycin, and ciprofloxacin.
• Ear drops: It is possible to be administered ear drops to aid with infection prevention, pain relief, and inflammation reduction. Antibiotics, steroids, or a mix of the two may be included in ear drops. Examples of ear drops that may be used include neomycin and polymyxin B sulphate and hydrocortisone ear drops.
• Pain relievers: It is possible to be administered ear drops to aid with infection prevention, pain relief, and inflammation reduction. Antibiotics, steroids, or a mix of the two may be included in ear drops. In some cases, prescription-strength pain relievers may be necessary.
• Decongestants: If a ruptured eardrum is caused by congestion, decongestants may be recommended to help reduce swelling and promote drainage. Examples of decongestants that may be used include pseudoephedrine and phenylephrine.
• Antihistamines: If a ruptured eardrum is caused by allergies, antihistamines may be recommended to help reduce inflammation and relieve symptoms. Examples of antihistamines that may be used include loratadine and cetirizine.

In India, the following are some estimated expenses for typical eardrum rupture treatments:

• Medications: Depending on the medication's kind and dose, the cost of treating a ruptured eardrum might change. Antibiotics, ear drops, and pain relievers may be prescribed and can cost anywhere from a few hundred rupees to a few thousand rupees.
• Surgery: If a ruptured eardrum requires surgical intervention, the cost can vary depending on the type of surgery performed. For example, a myringoplasty, which involves repairing the eardrum using a tissue graft, can cost between Rs. 20,000 to Rs. 50,000 or more, depending on the location and facility.
• Consultation fees: The cost of consultation fees with an ear, nose, and throat (ENT) specialist can vary depending on the location and experience of the doctor. Typically, consultation fees range from a few hundred rupees to a few thousand rupees.

You should be aware of the following possible negative effects:

• Antibiotics: Antibiotics often cause nausea, diarrhoea, and stomach distress as adverse effects. Antibiotics may trigger adverse responses or breed microorganisms that are resistant to them.
• Ear drops: Ear drops may cause temporary stinging, burning, or itching in the ear. Rarely, they could trigger an allergic response or irritability.
• Pain relievers: Acetaminophen and ibuprofen are two examples of over-the-counter painkillers that might lead to allergic reactions, headaches, and stomach discomfort. Prescription-strength pain relievers may cause drowsiness, dizziness, or nausea.
• Decongestants: Decongestants may have negative side effects such as anxiety, agitation, and trouble sleeping. These might sometimes elevate blood pressure or induce palpitations.
• Surgery: If a ruptured eardrum requires surgical intervention, there are risks associated with anaesthesia and the surgical procedure itself. Potential risks can include bleeding, infection, and hearing loss.