A perforated eardrum, also called a ruptured eardrum, comes about when a hole or tear develops in the eardrum. The eardrum is the part in the ear that vibrates when it comes into contact with waves of sound. Eardrum injuries are often extremely painful and, in some instances, can lead to infections or hearing loss. Fortunately, most injuries of this type will heal in a couple weeks with no ensuing problems. When an eardrum does not heal naturally, then a surgery may be required to restore normal hearing. 

The eardrum structure

The eardrum, or the tympanic membrane, is a cone-shaped and thin piece of tissue that divides the middle and outer ear. It is located at the end of the canal of the ear, or the section that typically builds up wax. The hearing process starts when the visible part of the ear, or the pinna, channels sound waves inside the ear canal. These waves then hit the eardrum, causing it to vibrate.  

The production of sound

Within the inner ear, these same vibrations turn into nerve impulses, all of which are converted by the cochlea. The impulses then continue to travel to the brain along the auditory nerve (sometimes referred to as the cochlear nerve). The auditory cortex in the brain receives the signals, then translates them into varying sounds. 

An eardrum injury: How it impacts hearing

If the eardrum is ruptured, it can disrupt the eardrum’s capacity to vibrate properly. If this happens, then one’s hearing can become diminished or muffled. The hearing loss is typically temporary and can differ in intensity, depending on the location of the ear damage and/or the size of the injury. In some instances, bacteria may enter the middle ear through the opening, thereby causing an ear infection to develop. The infection may cause a temporary loss of hearing or, in rare instances, permanent hearing damage and loss. 

How the eardrum may become ruptured

Many individuals are unaware that cleaning the ears with cotton swabs can cause damage to the eardrum. That’s because poking through the ear canal can readily damage the fragile tissue of the sensitive part. Other ways the eardrum can become perforated include the following— 

  • Fluid Buildup – A middle ear infection or an infection in the inner ear, such as otitis media, leads to a fluid build-up just behind the eardrum. If the build-up is too great, the eardrum can burst. This type of injury is often seen in children. 
  • Barotrauma – A sudden alteration in the barometric pressure can also perforate the eardrum. This occurrence can happen during scuba diving, air travel, or driving over a mountainous road. 
  • Acoustic trauma – Trauma or loud noises can also cause an eardrum to rupture. If the noise is very loud, such as an explosion, the sound waves may be strong enough to injure the eardrum. Any loud noise of this kind can also cause permanent or temporary hearing damage to the cochlea, all of which, in turn, can lead to a hearing impairment. 
  • External Objects – Besides the use of cotton swabs, other foreign objects, such as hairpins or similar items that can fit into the ear canal, can result in injury or deafness. 
  • Head Trauma – A head trauma can also produce damage to the eardrum. A temporary loss of hearing can occur when the ear takes a direct hit. 

Needless to say, if you experience an injury that affects your hearing, you need to check the damage and its extent without delay. While hearing loss is thought to be a condition associated with age, it can be impacted by injury, infection or trauma as well. Any damage to the ears or loss of hearing should be examined immediately.