Eardrums are vital, playing two vitally important roles in hearing. First of all they vibrate when sound waves hit them. Second they provide a barrier that safeguards the inner ear from infection. Whenever your eardrum is intact, your inner ear is essentially a protected and sterile environment; but once it has been perforated or torn, microbes may enter and spark a major infection known as otitis media.

The terms perforated eardrum and ruptured eardrum mean the same thing. They each reference a condition whose technical name is a tympanic membrane perforation where there is a puncture or tear in the thin membrane we know as the ear drum. A punctured eardrum can occur from many causes, the most common of which is an ear infection, which causes fluid to press against the eardrum membrane and ultimately cause it to rip. An additional common cause of punctured eardrums are foreign objects inserted into the ears. For example, it’s possible to puncture your own eardrum with a cotton swab. Eardrums can also become ruptured due to scuba diving or flying due to barotrauma, which occurs when the barometric pressure inside the ear is different from the pressure outside the ear. Eardrums can also become punctured due to head injuries or acoustic trauma such as sudden loud noises or explosions.

Warning signs of ruptured eardrums include pain in the ear (including persistent pain that stops suddenly), hearing loss in the affected ear, dizziness or vertigo, and fluid draining from the ear. A ruptured ear drum should be evaluated and treated by a professional. Swift attention is essential to prevent hearing damage and infection. Untreated, a ruptured eardrum can result in middle and inner ear infections, middle ear cysts (cholesteatoma), and permanent loss of hearing.

Doctors assess this condition using an otoscope, which is a tool with an internal light which allows them to see the eardrum. If your eardrum has been punctured, typically it will heal on its own within eight to 12 weeks, but during this time period you should refrain from diving or swimming, avoid certain medications, and try to avoid blowing your nose (which would place more pressure on the injured eardrum). If the tear is large or is located near one of its edges, the health care provider may insert a temporary dam or patch to prevent infection; in very rare situations, surgery may be needed.

Your health care provider may also order over-the-counter pain medications such as ibuprofen or acetaminophen to deal with any discomfort. The most important precautions you can take to avoid ruptured eardums are to 1) avoid inserting any objects into your ears, even to clean them, and 2) address ear infections without delay by visiting a doctor.