The eardrum, medically known as the tympanic membrane is a tissue which, on receiving sound waves, vibrates and responds to it. It is the thin tissue that works as a divider between the ear canal and middle ear. When we say the eardrum is ruptured, it means the tissue is torn, and this tear is medically known as perforation. So, a perforated eardrum or tympanic membrane perforation is a tear in the eardrum tissue.
A victim suffering from tympanic membrane perforation or a ruptured eardrum undergoes the following problems.
- Loss of hearing is the worst of all, after-effects.
- Experiencing a feeling of blockage in the affected ear.
- A continuous buzzing sound like that of a television with no signal.
- Nausea is a common after-effect as it affects the nervous system.
- If the victim blows through the nose, his ear tends to whistles.
- Blood drainage from the affected ear is a common sight.
The size of the hole in the eardrum states the severity of the damage. If the size of the hole or tear is big, the damage is more and vice-versa.
Reasons Leading To Tympanic Membrane Perforation
The eardrum can rupture due to an ear infection. The infection may be severe or mild. Medically known as acute otitis media, this occurs behind the eardrums in the space (known as the middle) where the tiny vibrating ear bones are present. Children get infected easily. The infection results in pus getting accumulated in the middle ear, which is a dangerous sign as it can damage the eardrum due to pressure and eardrum may experience a severe tear due to it.
Ear infections are quite painful. They also lead to partial or complete deafness.
Inserting Objects In The Ear
Ever felt the need to insert something in the ear when there are excess and uncontrollable itching. People believe the use of cotton buds to remove excess ear wax is not harmful, but if not done in the right way, can damage the eardrum. At times when the itching becomes uncontrollable people try to ease it down by inserting objects like pencil or bobby pin as well. Doing so can be extremely dangerous and can lead to tympanic membrane perforation.
Children often become a victim due to the lack of knowledge, and in the severity of the situation tend to insert objects in the ear accidentally. Therefore, parents need to be extra cautious, and any early signs must be given serious medical attention.
Traumatic Injury In The Ear
Falling on the side of the head may lead to a forceful blow leading to a traumatic head injury or in some cases, can even lead to tympanic membrane perforation. The ear tissue is fragile and can rupture easily. Sometimes the blow can be fatal enough to damage the inner and middle ear leading to a more severe condition.
Cauliflower ear from wrestling is an example of a severe injury occurred at contact sports like wrestling that may lead to tympanic membrane perforation.
Unbearable Loud Noises
“Lower down your decibels!” is the common phrase we all encounter when one gets irritated due to loud music or noises. Loud music at religious ceremonies and weddings is strongly discouraged by people. It is because the harm it can provide to someone’s ears. The eardrum vibrates according to the frequency of the sound wave and the higher the rate, the faster is the vibration.
Listing to music at higher octaves with earplugs on is discouraged as well. The reason is that doing so can seriously damage the tympanic membrane and may cause perforation. Becoming habitual can prove fatal as people listening to higher music often become deaf to low sounds.
Ear barotrauma is a condition faced by the person leading to severe pain in the middle ear due to change in air or water pressure. Too much change in the air or water pressure leads to pressure on the tympanic membrane, which may lead to perforation.
The eustachian tube that connects the middle ear to the back of the nose and throat is responsible for maintaining the equilibrium in pressure on either side of the eardrums. In the event of high air or water pressure, the tube might not open, and the unequal pressure can lead to tympanic membrane perforation.
The best examples of experience air and water pressure are aeroplanes and scuba diving. Planes fly at 35000 ft above sea level and at that alleviation the air pressure is extreme. Albeit, planes are designed to minimize the air pressure, in cases of aeroplane turbulence the pressure might increase in passenger cabins leading to a perforation in the eardrum in some people.
Scuba diving is a kind of deep diving performed by people as a fun sport to witness the aquatic world of corals and fish. But the deeper you dive into the depths of the ocean, the heavier the pressure gets. This heavy pressure may lead to tympanic membrane perforation as the pressure can create a vacuum in the middle ear, pulling the eardrum to the inner side and resulting in a rupture.
Treatments To Prevent Eardrum Perforation
The first and foremost important step is to consult a doctor and get medical treatment for the same.
An ENT doctor has a specialization in the treatment of ear-related conditions. He/she examines the conditions with the help of an instrument called an otoscope. This instrument helps them to determine whether the tympanic membrane has been perforated or not, and if it has been, then what is the size of it.
Doctors also carry out a series of hearing and balance tests to test the severity of the condition. Blowing air into the ear is often preferred by them as a testing procedure.
Eardrums have self-healing powers. A ruptured eardrum can heal in 1-3 months. In case the pain is mild, a warm compression on-ear can relieve one from the pain. In case the ear experiences aches and inflammation, then it is advisable to take non-steroidal anti-inflammatory drugs (NSAIDs) for quick relief.
Doctors normally prescribe oral antibiotics and ear drops for curing an infection. In case the damage of the tympanic membrane is severe due to which the membrane is not able to recover by itself, then, a surgical procedure called tympanoplasty is usually performed in order to repair the membrane.
Keeping the ear dry impedes speeding the process of healing. It is also essential for preventing a middle ear infection from occurring.
While taking a bath, keeping the medication protected is extremely important. To prevent water from seeping inside the ear, wearing watertight earplugs or cotton wool ball can help. You can also block the ear with the coating of petroleum jelly. It is also recommended to refrain from water sports or activities like swimming for quick recovery of the eardrum.
Blowing from the nose can become problematic. Remember, we discussed that the eustachian tube connects the middle ear to the back of the nose and throat and is, therefore, responsible for maintaining the equilibrium in pressure on either side of the eardrums. So if a patient under medication blows the nose too hard, it can lead to excessive pressure on the tube resulting in delays in recovery. A gentle exhalation through one nostril is recommended.
Insertion of any object inside the ear is strictly prohibited, and we have discussed in detail as to how can inserting objects in ear lead to accidents. People must refrain from such activities.
Addressing the problem at an early stage is recommended so that proper medication can be given to victims on time to avoid worsening of situations further.
Vaccination is the best way to prevent a problem from occurring as it eliminates the possible symptoms from the body, making the host’s body less susceptible to infections. Flu jab or pneumococcal vaccination, lower the risk of ear infections in the first place.
Centres for Disease Control and Prevention (CDC), states that breastfeeding a child exclusively for a period of six months post-birth and ten continuing the same for a total of 12 months can reduce the chances for infections in his body as the breast milk strengthens the immune system of the baby. Chances for having ear infections can be considerably reduced as children are more susceptible to having infections than adults.
Surprisingly, giving up smoking or inhaling secondhand smoke can reduce the risk of ear infections. The air and water pressure needs to be appropriately maintained for the eustachian tube to remain open and to work properly so that the occurrence of ear barotrauma can be prevented.
To prevent ear barotrauma from occurring due to a change in air pressure, one can take the following precautions while flying.
- Swallowing frequently keeps your mouth working. This, in turn, helps to lower the pressure.
- One of the many benefits of chewing gum is the synchronous movement of jaws cutting out the excessive pressure. Sucking hard candy is also advisable.
- Yawning or opening a mouth hard helps to keep out the excessive pressure and even relieves one of ear pain experienced during the air travel.
- Blocking nostrils with fingers and breathing out of closed mouth pushes the air through the ears, thus preventing the pressure to create a vacuum in the middle ear.
- One of the best ways is to wear earplugs designed specifically for air travel. They block the ear passage, thus preventing the occurrence of vacuum in ears.
Having a cold nose and travelling via air can prove to be challenging. Taking a decongestant is important for letting the nostrils to work properly.
While Scuba diving, it is always recommended to dive slowly. This helps in equalizing the water pressure in ears. One must refrain from diving if one is suffering from cold or having symptoms of allergy. Following a professional’s advice is highly recommended before attempting scuba diving.
People suffering from ear barotrauma must not fly or dive until their doctor declares it safe for them. To prevent the frequent occurrence of barotrauma, the doctor may need to insert a ventilation tube inside the patient’s eardrum to keep the eustachian tubes open. It helps in maintaining the balance of air pressure in the eardrum.
Although the government has started taking strict actions against loud music in public places, still one must keep protection in hand as self-awareness is the best defence. Therefore, one must block the ears with earplugs in situations when one experiences unbearably loud noise. The best, e.g. of prevention, is shooters wearing earmuffs while practising shooting in a shooting range. Similarly, welders also use earplugs to prevent the ears from getting damaged during welding.
Prevention is always better than cure. The detailed description above highlights how one can save one’s ears if one takes proper precautions.
In case the eardrums get ruptured, taking proper medication is extremely important. In most cases, eardrums heal by themselves in 1-3 months but are the condition is too severe, thus preventing the ear from self-healing then one must consult an Otolaryngologist without further delays.
The ears must remain dry during medication or tenure of the treatment, and the same can be done by adopting ways to prevent water from seeping in the ears. Any activity that involves contact with water is strongly discouraged.
In cases of serious ear barotrauma, one must refrain from diving and flying as the extreme air, and water pressure can make the situation worse. This must follow professional advice, and with proper permission of the doctor only, one must look forward to doing these activities.
Ears are the most important and delicate part of the human body. Being the external organ, they are susceptible to damage. A minor itching, if not addressed properly, can prove to be fatal, therefore inserting objects inside the ear in an attempt for quick relief might turn out to be a fatal accident. Production of ear wax is normal, and ears must remain clean and healthy, but the same must be done with excessive care as it can result in severe damage.