A healthy living blog from Marshfield Clinic Health System

What can cause a perforated eardrum?

Your eardrum is a sensitive spot on your body. This small membrane collects and amplifies sounds that come into your ear canal.

What happens if there’s a hole or perforation in your eardrum? Potential hearing loss and infection are two concerns.

Infection can be a cause and an outcome

girl whispering in mom's ear

Eardrum perforation can be caused by an infection behind the eardrum or from trauma, like a blow to the ear from a cupped hand.

Eardrum perforation can be caused by an infection behind the eardrum or from trauma, like a blow to the ear from a cupped hand. Other chronic ear problems like deep retraction pockets, recurring drainage and cholesteatoma, a skin cyst, also can affect your eardrum’s health.

If a perforation forms, more debris can enter your ear and cause infections. Hearing loss is the most common problem with a perforation. The extent of the hearing loss depends on the size and location of the perforation. Skin also can grow around or behind the margin of the perforation, creating cholesteatoma.

“Many times, your ear will not get infected and can be left without closing the perforation,” said Kenneth Condon, M.D., a Marshfield Clinic otolaryngologist. “But there will be hearing loss and the potential of infection.”

How is an eardrum perforation treated?

Some perforations will heal without needing surgery to repair. One fix is a paper patch that can be placed over the perforation to speed up the healing process.

“If the perforation doesn’t close spontaneously within six months, surgery may be required,” Dr. Condon said.

Usually, tissue is taken from around the ear to use as graft material. A piece of tissue or cartilage is removed, and the graft is placed behind the eardrum. Once the graft takes, the hearing loss caused by the perforation improves.

“The main approach to repairing the eardrum is through the ear canal,” Condon said. “The canal is visualized with a microscope or fiber optic endoscope.”

Side effects of eardrum surgery may include failure of the graft, causing a persistent hole in the eardrum and hearing loss and an alteration of taste. This is caused if a small nerve underneath the eardrum, which connects to the mouth, becomes unprotected, affecting the tongue’s taste buds.

After surgery, you should avoid getting water into the ear canal while it heals, and hard nose-blowing and flying.

Eardrum perforation surgery is done on an outpatient basis and can be performed on children and adults.

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