The ear is divided into 3 parts. This is the outer ear, the middle ear and the inner ear. The middle ear is separated from the middle ear by the eardrum otherwise known as the tympanic membrane.  The eardrum is a very thin layer of tissue. This acts as a membrane to transmit vibrations from the outer ear to the hearing bones in the middle ear. Because it is so thin, the eardrum can be ruptured or punctured. This can happen from in an infection or from trauma.

Perforated Ear Drum

Causes of Perforations

Infections from bacteria, viruses and fungi. This can arise from the outer or middle ear. In children, the commonest infection is otitis media. This create an increase in pressure in the middle ear. The middle ear is then filled with fluid and pus. This stretches the ear drum causing pain and fever. When the ear drum can no longer withstand the pressure, it perforates releasing the middle ear fluid and pus.

Trauma from a penetrating object such as a cotton bud or metal curette can cause a perforation. Sudden changes in pressure from a slap on the ear, diving or in a plane can also burst the ear drum. Shock waves from loud sounds such as lightning bursts, blasts from guns and fireworks can cause the ear drum perforation.

Signs of Perforated eardrum

  • Hearing Loss
  • Ringing or tinnitus
  • Vertigo or dizziness
  • Fluid or blood discharge from the ear

When there is any of the above, you should seek medical care. Most of the ear perorations are reversible if teated early.


The doctor will check your ear with an otoscope. Ear cleaning may be necessary if there is debris and infection. This is best down under a microscope. Tympanogram and audiogram may be necessary.

Treatment will depend on the cause of the perforation.

Precautions. When there is a perforation, avoid swimming and introducing water into the ear. You may need to be careful during bathing. Do not introduce cotton buds into the ear.