Medicines for Perforated eardrum

What it is

A perforated (burst) eardrum is a hole or tear in the eardrum — the thin layer of tissue that separates the ear canal from the middle ear and vibrates in response to sound. It has several common causes: a middle ear infection (where a build-up of pus and pressure behind the eardrum can cause it to burst, often relieving the pain and producing discharge); injury (such as poking something into the ear — including cotton buds, which should not be put in the ear — or a blow to the ear); a sudden loud noise (such as an explosion); and a sudden change in air pressure (barotrauma, for example while flying or diving). Symptoms can include sudden ear pain (which, with an infection, may ease as the eardrum bursts), discharge from the ear (which may be watery, bloody or pus-like), some hearing loss in the affected ear, ringing (tinnitus), and sometimes a feeling of the ear being blocked. The good news is that a perforated eardrum usually heals on its own, often within a few weeks, and the hearing typically returns as it heals. It is important to keep the ear dry while it heals and to avoid poking the ear, and any infection is treated. Occasionally, a perforation does not heal or causes ongoing problems, and may need treatment.

How it is treated

Most perforated eardrums heal on their own within a few weeks, so the mainstay is supportive care and protecting the ear while it heals. Key measures include keeping the ear dry — avoiding getting water into the ear (for example when showering or washing hair, and not swimming) until it has healed, as water in the middle ear could cause infection — and not putting anything into the ear (including cotton buds) or trying to clean it out. Pain relief helps any discomfort. Where the perforation was caused by, or is associated with, a middle ear infection, that is treated (for example with antibiotics if needed), and a doctor may prescribe treatment if there is infection or discharge. The ear is usually reviewed to check it is healing. If the eardrum does not heal on its own after a couple of months, or if there are ongoing problems (such as persistent hearing loss, recurring infections, or a chronic perforation), an ENT specialist may consider treatment, including a surgical repair of the eardrum (myringoplasty) in some cases. Avoiding future causes — such as not poking the ears, treating ear infections, and taking care with pressure changes when flying or diving — helps. The reassuring message is that a perforated eardrum usually heals on its own within weeks, with hearing returning, provided the ear is kept dry and not poked, and that persistent perforations can be treated if needed.