Tympanic Membrane Perforations
A tympanic membrane perforation, or a hole in the eardrum, can occur in children for a variety of reasons. The eardrum is a thin membrane that separates the outer ear from the middle ear and plays an important role in hearing. Perforations may happen after a middle ear infection (otitis media), especially if pressure from fluid buildup causes the eardrum to rupture. They can also result from trauma, such as inserting objects into the ear like cotton swabs. Tympanic membrane perforation can also occur with a sudden loud noise or trauma to the head.
Signs and symptoms of a perforated eardrum can vary. Some children may complain of ear pain that suddenly improves, followed by drainage from the ear which may be clear, bloody, or pus-like. Other symptoms can include hearing loss, a feeling of fullness in the ear, or ringing (tinnitus). In some cases, children might not show obvious signs, and the perforation is only discovered during an ear exam. While some small perforations heal on their own within a few weeks, others may persist and lead to repeated infections with drainage or long-term hearing issues.
A healthcare provider can diagnose a perforated eardrum by examining the ear with an otoscope. If there is any discharge, they might take a sample to identify infection. We may also recommend an audiogram (hearing test) to understand the impact of the perforation on hearing. Keeping the ear dry and avoiding further trauma is crucial during the healing period. Our providers may prescribe antibiotic drops if there is evidence of infection.
If the perforation does not heal on its own after a few months surgical repair may be recommended. This procedure is called tympanoplasty. The procedure is done under general anesthesia and involves grafting a small piece of tissue to close the hole in the eardrum. Tympanoplasty is generally safe and has a high success rate, with most children recovering fully within a few weeks.
Parents can help prevent eardrum perforations by avoiding the use of cotton swabs or any objects in the ears and treating ear infections promptly. If your child experiences frequent ear infections or hearing difficulties, regular follow-up with our specialist is important. With proper care and treatment, most children with tympanic membrane perforations recover well and go on to have normal hearing.
If you’re concerned about your child’s ear health, please reach out to us to arrange a consultation.