The ear drum, is usually a paper thin membrane that looks like saran wrap. A hole or is called a perforated eardrum. A perforated eardrum is often accompanied by decreased hearing and occasional discharge. Pain is usually not a symptom. Perforated eardrums are usually caused by infection such as otitis media or trauma such as a slap on the outer ear, or putting a foreign object in the era (i.e. bobby pin, stick, etc).
Rarely, a small hole may remain in the eardrum after ear tube surgery as the tube falls out or is removed by otolaryngologist.
Most eardrum perforations heal on their own within weeks of rupture, although some may take several months to heal. During the healing process the ear must be protected from water and trauma. Eardrum perforations that do not heal on their own may require surgery.
Most common feeling and symptom with a hole is hearing loss. You may feel a clogged sensation or a true decrease in your hearing.. If severe trauma (e.g., skull fracture) dislocates the bones in the middle ear which transmit sound, or injures the inner ear structures, hearing loss may be worse. If the perforated eardrum is caused by a sudden traumatic or explosive event, the loss of hearing can be great and tinnitus (ringing in the ear) may be severe. In this case, hearing usually returns partially, and the ringing diminishes in a few days. Chronic infection as a result of the perforation can cause persistent or progressive hearing loss.
Before attempting any correction of the perforation, a hearing test should be performed. Closing the hole is performed in many ways. Small ones can be watched as the eardrum has an ability to heal itself. Small or medium ones can be closed in the office by either placing a small fat graft obtained under local anesthesia or placing a sticky paper “patch” over the hole to allow the ear drum to heal itself. Larger ones will require a true surgical procedure with either a skin, cartilage or soft tissue graft placed over the hole.
Closing the hole is important as we have learned that leaving the perforation can lead to other medical problems, such as persistent hearing loss, chronic ear drainage and infection and worse a condition known as Cholesteatoma. A cholesteatoma is an accumulation of debris (dead skin cells and external debris) that can lodge itself like a ball behind the perforation in the middle ear. If left without treatment the cholesteatoma can grow with more dead cells and erode structures in the middle ear including the tiny ear bones. It can also grow into the sinus behind the ear, the mastoid sinus. If any of these occur, then more extensive surgery is needed.
Your doctor will advise you regarding the proper management of a perforated eardrum.