Ruptured Eardrum (Eardrum Membrane Rupture): Symptoms, Causes, and Treatment
Updated: 2 days ago
Medically reviewed by [Dr. Baraa Alnahhal, MD](https://www.rinnit.com/dr-baraa-alnahhal). Last reviewed October 17, 2026. This content is for educational purposes and is not medical advice.
Quick Answer
A ruptured eardrum is a hole or tear in the tympanic membrane, the thin tissue between the ear canal and middle ear [1]. It can cause ear pain, drainage, muffled hearing, ringing or a spinning feeling [1]. Causes include middle ear infections, pressure changes, loud blasts and head trauma [1]. Most tears heal on their own in a few weeks [1] [2].
What the research says
Patching or ear drops helped large traumatic tears close faster. In 136 patients with large traumatic perforations, closure at 6 months was 97.6% with ofloxacin ear drops, 87.2% with a gelatin sponge patch, and 79.2% with spontaneous healing; average time to closure was about 13, 16, and 50 days (Li et al., Braz J Otorhinolaryngol, 2022) [3].
Hearing loss from a perforation is usually mild to moderate. Pooling 16 studies, the average air-conduction hearing threshold was 48.3 dB HL in adults and 31.9 dB HL in children with a perforation (Hampton et al., Clin Otolaryngol, 2025) [4].
Active ear discharge did not worsen surgical results. A review of 33 studies (2,373 patients) found that, in the 7 studies pooled for meta-analysis, hearing gain and graft uptake after tympanoplasty were not significantly different between active and inactive otitis media (mean hearing gain difference −0.76 dB, 95% CI −2.11 to 0.60) (Wong et al., Otol Neurotol, 2023) [5].
Key Facts at a Glance
What is a ruptured eardrum?
The eardrum sits between the ear canal and the middle ear. A perforated or ruptured eardrum is a hole or tear in this thin tissue [1]. The medical name is tympanic membrane perforation [1].
The eardrum has two main jobs. It supports hearing: when sound waves strike it, the eardrum moves [1], which is the first step in turning sound into nerve signals. It also protects the middle ear from water, bacteria, and other things that do not belong there [1].
A tear keeps sound waves from moving to the middle ear the way they should. The tear can also leave the middle ear open to infection-causing things like water. The good news is that a ruptured eardrum most often heals in a few weeks without treatment [1] [2]. But some tears might need a patch or surgical repair to heal [1] [2].
What are the symptoms of a ruptured eardrum?
A ruptured eardrum can cause several symptoms at once. The signs can appear quickly, especially after an infection or a sudden pressure change.
When should you see a doctor about a ruptured eardrum?
Make a medical appointment if you have symptoms of a ruptured eardrum [1]. Early care helps protect the middle ear while the tear heals.
What Causes a Ruptured Eardrum?
Five things most often lead to a ruptured eardrum. In each case, the pressure inside or outside the ear overpowers the thin membrane, or something damages it directly.
Middle ear infection (also called otitis media) is a leading cause. A middle ear infection often occurs because of a buildup of fluid in the middle ear [1]. Pressure from this fluid can cause the eardrum to rupture.
Barotrauma is stress on the eardrum when the air pressure in the middle ear and the air pressure outside the ear are out of balance. If the pressure is bad enough, the eardrum can tear. Barotrauma is most often caused by air pressure changes during air travel [1]. Other things that can cause sudden pressure changes include scuba diving and something hitting the ear hard, such as an automobile air bag [1].
Loud sounds or blasts, also called acoustic trauma, rarely can cause a tear. An explosion or gunshot are examples [1].
Putting things in the ear is another cause. Small objects such as a cotton swab or hairpin can poke through or tear the eardrum [1].
Severe head trauma can also rupture the eardrum. A severe injury such as a skull base fracture may damage the middle and inner ears [1], including the eardrums.
Cause | How It Tears the Eardrum |
Middle ear infection | Fluid buildup creates pressure that can rupture the eardrum |
Barotrauma | Air pressure imbalance inside vs. outside the ear, often from flying; also scuba diving or an air bag strike [1] |
Loud blasts | Very loud sounds such as explosions or gunshots rarely cause a tear [1] |
Objects in the ear | Cotton swabs or hairpins can poke through or tear the membrane [1] |
Severe head trauma | A skull base fracture can damage the middle and inner ears [1] |
Who Is at Higher Risk?
Anyone can develop a ruptured eardrum, but risk rises with certain exposures. Frequent flying with a cold or allergies, scuba diving, working around loud noise, using objects to clean the ears, and having repeated middle ear infections all raise the odds. Children with middle ear infections are especially at risk because fluid pressure builds behind the eardrum.
What Happens If It Is Left Untreated?
The eardrum has two main roles: hearing and protection. When it ruptures, problems can happen — especially if it does not heal after 3 to 6 months [1]. Complications are not common [1], but they include the following.
Hearing loss. Usually, hearing loss is short-term and lasts only until the eardrum heals. Where the tear is and how big it is play a role in how much hearing is lost [1].
Middle ear infection. A ruptured eardrum can let bacteria into the ear. A small number of people might get repeated or ongoing (chronic) infections if the hole does not heal [1]. This small group might have ongoing fluid leaks from the ear and hearing loss.
Middle ear cyst (cholesteatoma). Although rare, a rupture that does not heal can form this cyst in the middle ear [1]. It is made up of skin cells and other debris. Ear canal debris normally travels out of the ear with the help of earwax. If the eardrum is torn, the skin debris can pass into the middle ear and form a cyst. The cyst lets bacteria grow and has proteins that can damage the bones of the middle ear [1].
Complication | How Often | What It Means |
Hearing loss | Usually short-term | Lasts until the eardrum heals; size and location of the tear matter [1] |
Middle ear infection | Uncommon | A small number of people get chronic infections if the hole does not heal [1] |
Middle ear cyst (cholesteatoma) | Rare [1] | A cyst of skin cells and debris can form and damage middle ear bones [1] |
How is a ruptured eardrum treated?
Most ruptured eardrums heal on their own in a few weeks without treatment [1] [2]. If a tear does not close on its own, it might need a patch or surgical repair to heal [2]. Seek medical care so a clinician, such as an ear, nose, and throat (ENT) doctor, can watch the tear as it heals and decide whether more help is needed. While it heals, keep the ear dry (no swimming, and loosely plug the ear when showering), do not blow your nose hard, and do not put any drops in the ear unless a clinician prescribes them.
How can you prevent a ruptured eardrum?
Four habits cover most of the risk.
Get treatment for middle ear infections. Be aware of the symptoms of a middle ear infection. They include earache, fever, stuffy nose, and not hearing as well [1]. Children with middle ear infections often are fussy and may refuse to eat [1]. Seek medical care right away to prevent damage to the eardrum.
Protect your ears while on airplanes. If possible, do not fly with a cold or an allergy that causes the nose or ears to be stuffed up [1]. During takeoffs and landings, keep ears clear with pressure-equalizing earplugs, yawning, or chewing gum [1]. You can also use the Valsalva maneuver [1] — gently pushing air into the nose, as if blowing your nose, while pinching the nostrils and keeping the mouth closed. Do not sleep while the plane is taking off or landing [1].
Keep things out of the ears. Do not use a cotton swab, paper clip, or hairpin to dig out earwax [1]. These can tear the eardrum. Teach children about the damage they can do by putting things in their ears [1].
Guard against loud noise. Stay away from loud noises. If you have to be around loud noise, such as at work, wear earplugs or earmuffs [1].
How should you prepare for a ruptured eardrum appointment?
Before your visit, write down your symptoms and when they started. List all medicines, vitamins, and supplements you take [2], plus any skin or medicine allergies and the questions you want answered.
Good questions include what is causing your symptoms, what treatment you can expect, and how to prevent the eardrum from tearing again. Be ready for the clinician's questions too, including any recent ear infections, flights, dives, or ear cleaning habits [2].
Conclusion and Next Steps
A ruptured eardrum is a hole or tear in the thin membrane between the ear canal and the middle ear. It usually follows a middle ear infection, a pressure change, a loud blast, an object in the ear, or a severe head injury. The pattern to remember is simple: ear pain that fades fast, drainage, muffled hearing, ringing, or spinning.
Most tears heal within a few weeks without treatment. Some need a patch or surgery. If the tear has not healed after 3 to 6 months, complications such as chronic infection or a middle ear cyst become possible, so ongoing care with an ear, nose, and throat (ENT) doctor matters.
Take the next step: If ear pain, drainage, or hearing changes do not improve within a couple of weeks, see a healthcare provider as soon as possible.
Frequently Asked Questions
Does a ruptured eardrum heal on its own?
A ruptured eardrum most often heals in a few weeks without treatment. But it might need a patch or surgical repair to heal if it does not close on its own.
What are the first signs of a ruptured eardrum?
Ear pain that may go away fast, drainage of mucus, pus, or bloody fluid from the ear, hearing loss, ringing in the ear, and a spinning feeling are the typical signs.
Why does my ear hurt and then suddenly feel better?
The pain of a ruptured eardrum may go away fast once the eardrum tears and pressure releases, even though drainage and muffled hearing may follow.
Can a ruptured eardrum cause permanent hearing loss?
Hearing loss is usually short-term and lasts only until the eardrum heals. How much hearing is lost depends on where the tear is and how big it is.
How do you protect your ears on airplanes?
Avoid flying with a cold or allergies, keep ears clear during takeoffs and landings by yawning, chewing gum, or using pressure-equalizing earplugs, try the Valsalva maneuver, and do not sleep during takeoff or landing.
How do doctors check for a ruptured eardrum?
A provider looks into the ear with a lighted tool called an otoscope. Hearing tests or a quick middle ear pressure test may also be done.
Can I get my ear wet with a ruptured eardrum?
Keep the ear dry while it heals. Avoid swimming, and loosely plug the ear when you shower, because water can carry germs into the middle ear.
Can I use ear drops for a ruptured eardrum?
Use only ear drops that a clinician prescribes for a torn eardrum. Some over-the-counter drops are not safe when the eardrum has a hole.
When does a ruptured eardrum need surgery?
Surgery is considered when the hole does not close on its own, usually after a few months. An ear, nose, and throat doctor may place a patch or repair the eardrum with a small graft.
Can a cotton swab rupture an eardrum?
Yes. Cotton swabs, hairpins, or other objects pushed into the ear can poke through or tear the eardrum. Clean only the outer ear.
Trusted External Resources
Related Reading
Tympanometry: What It Is, How It's Done and What Tympanogram Results Mean explains the quick middle ear test that can point to this condition.
References
Mayo Clinic Staff. Ruptured eardrum (perforated eardrum) - Symptoms & causes. Mayo Clinic. September 5, 2025. https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/symptoms-causes/syc-20351879
Mayo Clinic Staff. Ruptured eardrum (perforated eardrum) - Diagnosis & treatment. Mayo Clinic. September 5, 2025. https://www.mayoclinic.org/diseases-conditions/ruptured-eardrum/diagnosis-treatment/drc-20351884
Li X, Zhang H, Zhang Y. Repair of large traumatic tympanic membrane perforation using ofloxacin otic solution and gelatin sponge. Braz J Otorhinolaryngol. 2022;88(1):9-14. PMID 32456874. https://doi.org/10.1016/j.bjorl.2020.03.007
Hampton T, Sanderson A, Mortimer K, Bhutta M. Systematic Review and Meta-Analysis of Audiometric Parameters for Assistive Hearing Technology for Adults and Children With Tympanic Membrane Perforation. Clin Otolaryngol. 2025;50(4):589-599. PMID 40025845. https://doi.org/10.1111/coa.14295
Wong ZY, Park YS, Mann GS. Postoperative Outcomes After Tympanoplasty for Active Versus Inactive Otitis Media Patients With Tympanic Membrane Perforation: A Systematic Review and Meta-Analysis. Otol Neurotol. 2023;44(7):643-650. PMID 37400232. https://doi.org/10.1097/MAO.0000000000003940
Medical disclaimer
The information provided in this article is for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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