Eardrum rupture (eardrum rupture) – causes, complaints & therapy

A rupture of the eardrum is a rupture of the eardrum, associated with stabbing earache, hearing loss and a dull feeling in the inner ear. The injury or tear can sometimes lead to light ear bleeding.

If germs or pathogens (bacteria) penetrate into the open skin area, an infection (middle ear infection) can threaten. As a rule, the rupture of the eardrum heals on its own. If this is not the case, the otolaryngologist must splint the affected area in order to allow it to grow together.

Causes

Direct causes of tympanic membrane rupture

A ruptured tympanic membrane can be caused by foreign objects or objects. Many people remove earwax from the ear with cotton swabs or similar objects, causing a ruptured eardrum. Otolaryngologists warn against this way of cleaning the ears. Burns and burns can also cause a rupture of the eardrum, e.g. during welding work above the head, when hot particles drip into the ear and burn the eardrum.

Indirect causes of tympanic membrane rupture

The indirect causes of tympanic membrane rupture include injuries caused by pressure fluctuations. e.g. in the event of an explosion, a jump into the water or a slap in the face. Even with a middle ear infection, overpressure in the ear due to blocked tubes can lead to a rupture of the eardrum.

During air travel, there may be problems with pressure equalization, especially during take-off and landing of the aircraft it can lead to an injury.In the case of colds or middle ear infections, associated with blocked tube (connection between middle ear and nasopharynx), doctors often issue a flight ban. In case of problems with pressure equalization, a decongestant nasal spray helps.

Strong pressure fluctuations can also occur when diving. Especially during downward diving, the pressure in the inner ear increases sharply. If cold water gets into the ear, irritation of the vestibular organ in the inner ear can cause dizziness and nausea.

People who have already been affected by a ruptured eardrum are more at risk of suffering another injury.

Symptoms and course

In most cases, a ruptured tympanic membrane is felt by a brief, stabbing pain in the ear. In addition, it may bleed from the ear canal or experience hearing loss. The pain occurs immediately after the rupture of the tympanic membrane, unlike overpressure, where the pain can appear even before the rupture.

With a smaller rupture of the tympanic membrane, the hearing impairment is less than with a more severe eardrum injury (with injury to the ossicles). In this case, there may be slight bleeding from the ear.

Dizziness and nausea are also among the symptoms if the inner ear has been irritated or injured. Due to a pronounced eardrum rupture, a middle ear infection can threaten. In worse cases, even facial paralysis and damage to hearing up to deafness.

Diagnosis

If there is a suspicion of a ruptured tympanic membrane, the doctor first questions the patient. In the conversation, the doctor clarifies the possible causes (by diving, air travel, loud bang, etc.) of the eardrum rupture. Subsequently, the doctor examines the ear thoroughly.

With the help of an ear mirror (otoscope) and a special microscope, the specialist can see whether there is a rupture. In addition, hearing tests provide information about the type and extent of the injury. If the eardrum was ruptured by an object or by liquid metal on the eardrum, an X-ray is also taken.

treatment and therapy

A slight rupture of the eardrum does not require more intensive therapy, it usually heals on its own in a short time. If the edges of injuries are turned inside out, they can be smoothed out for better healing. If healing does not occur within a few weeks, the eardrum rupture must be surgically closed. The therapy generally depends on the size of the eardrum rupture.

If foreign objects or water get into the ear, the doctor will prescribe an antibiotic to prevent bacterial infections. The ear must be kept clean and dry during the healing phase and, if necessary, closed with cream-soaked cotton wool while showering.

If the edges of the injury are severely curled, the doctor can splint the eardrum with the help of a silicone foil in order to promote better healing or, in the case of more extensive damage, he can reconstruct the eardrum from the body’s own tissue using a myringoplasty and fill in missing areas of the eardrum. After the reconstruction, the membrane is splinted with a silicone foil. In addition, he may insert a piece of gauze soaked in an antiseptic solution into the ear to prevent infection, as larger infections could permanently damage the ear.

Prevention

A rupture of the eardrum cannot always be avoided, but you can take precautions. If you want to dive, you should have your ears examined by a doctor beforehand. Before a flight, the pressure compensation should work without any problems.With colds and otitis media, it is better to postpone the flight. Otherwise, a nasal spray can help against clogged tubes, chewing gum during the flight, swallowing or the so-called Valsava maneuver, in which you pinch your nose and pump air into it.Anyone who is exposed to very loud noises should wear hearing protection to avoid rupturing the eardrum. Earwax should generally only be removed very gently and carefully because of the risk of eardrum rupture.