A perforated eardrum is a hole or tear in the thin membrane separating the ear canal from the middle ear. It can follow a middle-ear infection, a direct injury, inserting an object, a blast of very loud sound, or a rapid pressure change. Symptoms vary, and a small tear can sometimes be less painful than expected.
Symptoms and diagnosis
Symptoms may include sudden ear pain, discharge, muffled hearing, ringing, or dizziness. Pain can decrease after a perforation caused by pressure from an infection, but this does not prove that the problem has resolved. An ear examination helps identify the tear and look for infection or other injury; hearing tests may be needed.
Do not put drops, oil, or objects into the ear unless a clinician has confirmed they are safe for the eardrum. Avoid swimming and keep water out of the ear while it heals. Ask a clinician how to protect the ear during washing rather than inserting cotton deeply into the canal.
Healing and treatment
Many perforations heal on their own over several weeks, but healing time depends on the size and cause of the tear and whether infection is present. The clinician may recommend observation, treatment for infection, or follow-up hearing tests. A perforation that persists or causes ongoing hearing problems may need specialist treatment such as a patch or surgical repair.
Follow instructions about nose-blowing, flying, swimming, and medicines because these depend on the injury and individual circumstances. Do not stop prescribed medicines or use leftover antibiotic drops without advice; some ear preparations are unsuitable when the eardrum is not intact.
When to seek urgent care
Seek prompt assessment after an ear injury, sudden hearing loss, bleeding, significant discharge, severe dizziness, or intense pain. Urgent evaluation is especially important if the injury involved a sharp object, a slap or blow, or a head injury.
Arrange follow-up if pain, discharge, or hearing difficulty persists, or if you were told to have the eardrum rechecked. Even if pain settles, checking healing is important when symptoms began after trauma.
Common questions
Can I use ear drops with a perforated eardrum? Only use drops recommended by a clinician who knows the eardrum is perforated; some products may be unsafe for the middle ear.
Can I fly with a perforated eardrum? Advice depends on the injury, cause, symptoms, and planned travel. Ask the treating clinician before flying or diving.
Explore our tympanoplasty page for more information about this care option. A clinician can advise based on the individual history and examination findings.