Hole in the Eardrum, Perforated Eardrum, Ruptured Eardrum (Tympanic Membrane Perforation)

A hole in the eardrum is also known as tympanic membrane perforation. Other synonymous terms are perforated eardrum & ruptured eardrum. There are several reasons why this may happen including:

Trauma (getting slapped over the ear or deep q-tip insertion, etc)
Severe ear infection
Barotrauma
Ear tube placement

If the perforated eardum occurred suddenly (ie, traumatic, barotrauma, ear infection), treatment is initially with antibiotic ear drops +/- steroids. In the vast majority of the time, the perforated eardrum will heal closed over the ensuing weeks.

If the eardrum does not heal closed spontaneously with time or the hole has been present for longer than 3 months, a surgical procedure can be performed to close the hole either by:

Paper patch
- Low success rate, but very easy to perform with minimal risks. The paper patch is in essence a very thin paper placed over the hole. The paper patch acts as a scaffold to help the cells "cross" the hole over to the other side for closure.
Tympanoplasty
- High success rate, but requires general anesthesia performed in the operating room. In this surgical procedure, a new eardrum is made from the the patient's own body tissue.

Surgery is generally not recommended (even if a persistent hole in the eardrum is present) unless one (or both) of the following conditions are present:

Documented significant conductive hearing loss by audiogram
Recurrent ear infections

If these two conditions are absent, surgery is typically not recommended. Why? Just because there's a hole doesn't mean it has to be corrected unless it is causing a functional problem (just like a bunion of a foot doesn't have to be corrected unless it's causing problems).

Of course, if a perforated eardrum is present, do NOT use any over-the-counter ear drops or use any type of earwax removal liquid as these medications may cause a horrific earache as well as put your hearing at risk (permanently)!

Picture of a Perforated Eardrum (Hole is on Top)

If you have a perforated eardrum, please contact our office for an appointment.

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