Pediatric Tympanic Membrane Perforation (Ruptured Eardrum)

Pediatric Tympanic Membrane Perforation (Ruptured Eardrum)



Tympanic membrane perforation (also called ruptured eardrum) is a tear or rupture of the skin that separates the ear canal from the middle ear (eardrum).

Expanded overview

Hearing begins when sound waves first enter the ear canal and make the eardrum vibrate. When the skin is damaged between the ear canal and eardrum, sound waves cannot travel properly, causing hearing loss. The size and location of the tear will impact the degree of loss. An untreated tympanic membrane perforation or an extremely violent rupture can also lead to complications like middle ear infections (bacteria enters through the tear) or development of a cholesteatoma (a cyst in the middle ear).


Accidents, injuries and infections can cause tympanic membrane perforation. These include:

  • Acoustic trauma – loud sounds can tear your eardrum, especially explosive noises like gunshots or firecrackers.
  • Barotrauma – the eardrum ruptures due to extreme stress when pressure in the middle ear and the surrounding air pressure aren’t equal, often associated with pressure changes during air travel, scuba diving or trauma from an impact.
  • Foreign objects – any small item (like a cotton swab) that is pushed too far into the ear canal can tear and rupture the eardrum.
  • Head trauma  – severe injuries (like skull fractures) can damage the middle and inner ear structures.
  • Infections – ear infections can lead to fluid buildup in the middle ear, which causes pressure and can rupture the eardrum.


The severity of symptoms will depend on the type and level of the tear or rupture. Symptoms include:

  • Drainage from the ear (clear, milky, pus-filled or bloody)
  • Ear pain, which can continue or quickly end
  • Hearing loss
  • Nausea or vomiting 
  • Tinnitus (ringing in the ears)
  • Vertigo (severe spinning, unbalanced feeling)

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