Have you ever wondered why you need a healthy normal eardrum? The eardrum is a special ear membrane which protects the inner ear structures from infection and it also conducts sound to help you hear clearly. When the eardrum bursts or ruptures, there is a much higher risk of ear infection with hearing loss, ear discharge, dizziness, ringing sounds (tinnitus) and earache. In Singapore, top ENT specialists with a dedicated interest in ear conditions, see many patients who have perforated their eardrums, often due to underlying ear infection. Such patients with ruptured eardrums may also have had some difficulty trying to equalise their ear pressures, for example during a flight or while scuba diving. Forcing your eardrums to “pop” by blowing your nose with the nose pinched shut, may generate extremely high nasal pressures which, if transmitted via the Eustachian pressure tubes connecting to your ears, may lead to a sudden high pressure wave to injure and perforate your eardrum. Show
Many people love to swim and do water sports in Singapore but sometimes, water may enter the ear through the nose and up back the Eustachian tubes to lead to ear infections. The Eustachian pressure tube is often the source of ear troubles, as it can become inflamed and swollen from underlying nasal allergies (allergic rhinitis), sinus infections and viral attacks from the common cold virus or the flu virus. Interestingly, the Eustachian tube is usually closed in its resting state most of the time and only opens up, perhaps 4% of the entire time, in response to pressure variations at the end opening up at the back of the nose (see Figure 2 below) and the end facing outward towards the middle ear.  Sometimes, barotrauma (pressure injury) results in a perforated eardrum, most commonly during water sports such as scuba diving, where divers can descend as deep as 20m under the sea. Signs of ear barotrauma include sudden ear pain, ringing tinnitus in the ear, dizziness, hearing loss and bleeding from the ear. Some people just notice an ear “pop” sound alone or may even be completely unaware that their eardrum has perforated, until an ENT specialist in Singapore checks their ear to discover the hole in the eardrum during an ENT examination. Rarely, fluid buildup behind the eardrum might be related to a tumour growing at the back of the nose, which has enlarged to block off the Eustachian pressure tube lumen from deeper within. When the fluid accummulation is excessive, the eardrum may give way to perforate and release the pent-up middle ear pressurised fluid, leading to ear discharge and sometimes, ear pain. Many ruptured eardrums, if underlying infection has been properly treated, will heal on their own, usually within 6-8 weeks. However, eardrum perforations carry a higher risk of persistent ear discharge and ear infections in Singapore. Eardrum perforations are also often associated with hearing loss. If your ruptured eardrum hasn’t healed in 6-8 weeks, it is less likely to ever heal on its own. This means that you will have to make sure that no water enters your ear as this may lead to ear infection, without an intact eardrum present to protect the delicate structures of the inner ear. Eardrum perforations which fail to heal or close up by themselves, would need surgery to repair, by taking a healthy piece of tissue, called a “graft”, from the muscle behind your ear or the lining of the cartilage “bump” in front of your ear. For top ENT surgeons in Singapore who perform ear surgery very often, this is one of their favourite surgeries to undertake because there is a very high success rate with tympanoplasty or myringoplasty, surgical repair of the eardrum, as high as 98-99% success rate in uninfected eardrum perforations. This eardrum surgery may be done via the ear canal, sometimes endoscopically with a small camera, but sometimes also by approaching via a small incision in the ear canal or behind the ear for more complicated larger eardrum perforations with scarring. Let your doctor know if you experience these signs and symptoms of a perforated eardrum. It’s essential to seek treatment right away. Keep reading to learn more about what happens when you have a perforated eardrum. This article will review the symptoms, potential causes, and treatments involved. Understanding these potential causes and symptoms could ensure you receive the help you need for treatment. What is a Perforated Eardrum?The eardrum or tympanic membrane is the thin tissue that separates your middle ear and the ear canal. A tear in this tissue is called:
When your eardrum is ruptured, you can experience hearing loss. It can take a few weeks for your eardrum to heal without treatment. Otherwise, you might need a tympanoplasty or myringoplasty. A myringoplasty is sometimes done intentionally to relieve pressure, such as fluid build-up in the middle ear. The procedure repairs a small eardrum perforation using a paper-like material or gel foam. A tympanoplasty is a surgical reconstruction of a more extensive eardrum perforation and may involve scar tissue repair and a small skin graft to help repair the eardrum. How Is a Perforated Eardrum Investigated?Your Ear Health practitioner, general practitioner or otolaryngologist (ear, nose and throat specialist) can complete a visual exam to determine if you have a ruptured eardrum. They might need to conduct additional tests to determine if you’re experiencing hearing loss. Tests can include:
Before your appointment:
What Causes a Ruptured Eardrum?You might develop an ear infection, which could cause the eardrum to rupture. Otitis media is an infection of the middle ear that occurs when viruses or bacteria cause fluid build-up. The fluid or pus can build behind the eardrum, causing pressure. The eardrum might tear as a result. Trauma or injury to the ear can cause a burst eardrum, too. Ear tissue is thin and can tear easily. It could tear from a blow, such as from a sporting accident. Inserting an object into your ear can rupture your eardrum. Typical items include pencils, bobby pins, and cotton swabs. About 66% of the patients with ruptured eardrums hurt themselves by sticking “instruments” into their ears. Nearly half of these cases involved a cotton-tipped ear swab. A loud noise that occurs close to the ear could also cause a burst eardrum. For example, you could listen to music at a high volume. You might experience ringing in your ears (called tinnitus) for hours or days afterwards. Ear barotrauma occurs when there’s a difference in pressure between the inner and outer ear. Air travel and scuba diving can both cause ear barotrauma. What Are the Complications of a Perforated Eardrum?Your eardrum is responsible for two primary responsibilities: hearing and protection. When sound waves strike your eardrum, the eardrum vibrates. It’s then able to translate sound waves into nerve impulses. Your eardrum also acts as a barrier, protecting your middle ear from foreign substances. If you have a burst eardrum, your eardrum might not function properly. For example, you could develop hearing loss. Middle ear infections are common, too. Remember, the eardrum protects the middle ear from bacteria. If your ruptured eardrum fails to heal, it will leave your middle ear vulnerable. Developing a middle ear cyst is a potential complication as well. Though it’s rare, a cyst could form in the middle ear. Risk Factors of a Perforated EardrumYour chances of developing a ruptured eardrum can increase if you:
You can discuss ways to safeguard yourself from a potential burst eardrum with your healthcare practitioner. How Do You Prevent a Burst Eardrum?There are a few ways you can protect yourself from an eardrum injury or burst eardrum. First, treat any middle ear infections you experience right away. Possible symptoms include:
Let your doctor know if you experience these symptoms. You can seek treatment to protect against additional damage to your eardrum. The next time you plan on flying, protect your ears. Use pressure-equalising earplugs, chew gum, or yawn to avoid pressure changes. You should avoid flying if you have blocked ears or cold or flu-like symptoms. Make sure to keep your ears free of foreign objects. Avoid digging hardened ear wax out with a paperclip or cotton swab. Otherwise, you could risk tearing your eardrum. If you plan on attending an event where noise is an issue, protect your ears with earplugs. Possible Therapies and TreatmentTympanic membrane perforation has a spontaneous healing rate between 78 and 90%. If it fails to heal after six months, you could experience conductive hearing loss. Instead of waiting to heal on its own, visit a healthcare practitioner immediately. A general practitioner might prescribe antibiotic drops if you have a bacterial infection. If you’re in pain, they may recommend over-the-counter medication for relief. You can use home remedies to ease the pain as well. For example, consider placing a warm, dry compress on your ear throughout the day. Avoid blowing your nose more than necessary. Otherwise, you’ll create pressure in your ears. Increased pressure could slow the eardrum’s healing. A myringoplasty procedure might be suggested to close the tear. If the myringoplasty wasn’t successful, your doctor might recommend surgery. The most common surgical procedure for a perforated eardrum is called tympanoplasty. A surgeon will graft a patch of your tissue to close the tear in your eardrum. You can go home the same day unless anesthesia requires a more extended hospital stay. Larger perforations and tears at the edges of your eardrum may require surgery. If an ear infection caused your eardrum perforation, surgery could also help. Avoid swimming or diving while your eardrum heals, and use earplugs or a shower cap while bathing or showering. Top Share this article Subscribe Connect with Notify of Label Name* Email* Website
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How do you fix a popped eardrum from blowing your nose?Most ruptured (perforated) eardrums heal without treatment within a few weeks. Your provider may prescribe antibiotic drops if there's evidence of infection. If the tear or hole in the eardrum doesn't heal by itself, treatment will likely involve procedures to close the tear or hole.
How long does it take for a ruptured eardrum to heal?The opening in the eardrum most often heals by itself within 2 months if it is a small hole. Hearing loss will be short-term if the rupture heals completely. Rarely, other problems may occur, such as: Long-term hearing loss.
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Can you burst your eardrum from blowing your nose
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