Tympanic Membrane Perforation

What Is a Tympanic Membrane Perforation?

The tympanic membrane is also known as the eardrum. It is a thin, circular layer of tissue at the internal end of the ear canal. It is three layers thick and is the consistency of wax paper. Like the head of a drum, the eardrum vibrates when hit. Sound waves that are funneled down the ear canal set the eardrum into motion. This causes the tiny hearing bones (ossicles) to vibrate, transferring sound to the inner ear for processing. A tympanic membrane perforation, or hole in the eardrum, interferes with this process, resulting in hearing loss.

What Are the Symptoms of a Tympanic Membrane Perforation?

A tympanic membrane perforation may cause hearing loss as described above. You may also experience otorrhea, or ear drainage. Ears are normally waterproof, however, ears with perforated eardrums are no longer waterproof. Swimming, showering, sweating, and hearing aid use may all allow water through the hole in the ear drum. Infection and drainage from the ear may result from water exposure.

How Did I Get a Tympanic Membrane Perforation in the First Place?

Eardrum perforations may come from trauma. Rapid changes in pressure may occur with diving or flying. A blow to the ear may cause a perforation. Placing foreign objects into the ear such as Q-tips or other objects inserted to scratch the ears can damage the eardrum.

A completely separate category of eardrum perforation comes with infections. An ear infection with pus behind the eardrum if left untreated results in rupture of the eardrum. Long term, chronic ear infections weaken the ear drum so that perforations are easier to occur.

How Will My Doctor Test for an Eardrum Perforation?

A simple discussion of your symptoms combined with examination of your ear is enough to diagnose a perforation. It is useful to obtain a hearing test as well. This allows your doctor to understand the effect on your hearing. Less commonly, a CAT scan of the ear may be indicated in complicated perforation to assess the status of the related ear anatomy

Are Perforated Eardrums Treatable?

Some perforations will heal without any treatment. Those associated with chronic infections are less likely to heal on their own. These are treatable by a procedure called tympanoplasty. The tympanic membrane is exposed, the edges of the perforation are cleaned, and an autograft is used to rebuild the eardrum. This means that tissue from your own ear is harvested and shaped to repair the damaged area of the ear drum. Surgery is low risk, outpatient, and in most cases, results in improved hearing. After healing, the ear is usually waterproof again and there is no more drainage.