Perforated eardrum: main symptoms and treatment

When the eardrum is perforated, it is normal for the person to feel pain and itching in the ear, in addition to having decreased hearing and even bleeding from the ear. Usually a small perforation heals alone, but on larger ones it may be necessary to use antibiotics, and when that is not enough, it may be necessary to have a small surgery.

The eardrum, also called the tympanic membrane, is a thin film that separates the inner ear from the outer. It is important for hearing and when it is perforated, the person's hearing capacity decreases and can lead, in the long term, to deafness, if not treated correctly.

Thus, whenever you suspect a ruptured eardrum, or any other hearing disorder, it is important to consult an otolaryngologist to identify the problem and start the most appropriate treatment.

Main symptoms

Signs and symptoms that may indicate that the eardrum may be perforated are:

• Severe earache that comes on suddenly; Sudden loss of ability to hear; Itching in the ear; Blood leaking from the ear; Yellow discharge in the ear due to the presence of viruses or bacteria; Tinnitus in the ear; There may be fever, dizziness and vertigo.

Often, the eardrum perforation cures on its own without the need for treatment and without complications such as total hearing loss, but in any case, you should consult an otolaryngologist to assess whether there is any type of infection in the inner ear, that needs anabiotic to facilitate healing.

How to confirm the diagnosis

The diagnosis of perforated eardrum is usually made by an otorhinolaryngologist, who uses a special device, called an otoscope, which allows the doctor to view the eardrum membrane, checking if there is something like a hole. If so, the eardrum is considered perforated.

In addition to checking that the eardrum is perforated, the doctor can also look for signs of infection that, if present, need to be treated with antibiotics to allow the eardrum to heal.

How the treatment is done

Small eardrum perforations usually return to normal in a few weeks, but it can take up to 2 months for the membrane to regenerate completely. During this period it is necessary to use a small piece of cotton wool inside the ear whenever you shower, do not blow your nose, and do not go to the beach or the pool to avoid the risk of getting water in the ear, which can lead to the appearance of a infection. Ear washing is totally contraindicated until the lesion is properly healed.

Tympanic perforation does not always need treatment with drugs, but when there are signs of ear infection or when the membrane has completely ruptured, the doctor may indicate, for example, the use of antibiotics such as neomycin or polymyxin with corticosteroids in the form of drops for dripping into the affected ear, but it can also indicate the use of antibiotics in the form of pills or syrups such as amoxicillin, amoxicillin + clavulanate and chloramphenicol, the infection being usually fought between 8 and 10 days. In addition, the use of medications to relieve pain may be indicated by the doctor.

When surgery is indicated

Surgery to correct the perforated eardrum, also called tympanoplasty, is usually indicated when the membrane does not completely regenerate after 2 months of rupture. In this case, the symptoms must persist and the person returns to the doctor for a new evaluation.

Surgery is also indicated if, in addition to the perforation, the person has a fracture or impairment of the bones that form the ear, and this is more common when there is an accident or head trauma, for example.

Surgery can be done under general anesthesia and can be done by placing a graft, which is a small piece of skin from another region of the body, and placing it in place of the eardrum. After surgery the person must rest, use the dressing for 8 days, removing it in the office. It is not recommended to exercise in the first 15 days and it is not recommended to travel by plane for 2 months.

When to go to the doctor

It is recommended to go to the otorhinolaryngologist if there is a suspicion that the eardrum is perforated, especially if there are signs of infection such as secretion or bleeding, and whenever there is significant hearing loss or deafness in one ear.

What causes perforation in the eardrum

The most common cause of perforation in the eardrum is ear infection, also known as otitis media or external, but it can also happen when inserting objects in the ear, which especially affects babies and children, due to the misuse of the swab, in an accident, explosion, very loud noise, fractures in the skull, diving in great depth or during an airplane trip, for example.