Perforated Ear Drum

What Is a Perforated (Ruptured) Ear Drum? 

The ear drum is a thin but relatively tough barrier (like the top of a drum) that protects the middle ear space and bones in the middle ear from your ear canal.  It is translucent [allows light through (like wax paper) but not transparent (like plastic wrap)] meaning that it is a window but more like a dirty window.  It is possible to see things through the ear drum with a degree of accuracy but not with 100 percent accuracy.

The ear drum moves in and out with the pressure generated by sound waves and is influenced by atmospheric pressures from the outside and internal pressures determined by Eustachian tube function.  Fluid in the middle ear space is contained by the ear drum and also decreases its movement.  When the ear drum is ruptured, fluid drains into the ear canal and out of the ear.  Additionally, if the ear drum has a hole in it, it cannot move normally.  Whether the ear drum movement is decreased by fluid or by a hole, this translates into a decreased movement of the middle ear bones that function to amplify sound from the outside to the inner ear.  Therefore, a hole in the ear drum can result in a decrease in your hearing.

These can occur because of trauma (ex. cotton swabs, hairpins, other foreign bodies), spontaneously from pressure (ex. diving, flying, middle ear infection), certain infections of the ear drum, or from surgery.  Some of these holes will heal on their own others will cause little problem, especially if they are very small, still others will need to be surgically repaired due to hearing loss, repeated infection, or for protection from water.