Hole in the Ear Drum Discussion

During the summer the Ear doctor will see several people with a perforation in the ear drum after a diving injury. Usually the person hits the side of the head on the water causing a rupture of the ear drum. Slap injuries (“cuffing the ears”) can also cause rupture of the ear drum.

Most people only complain of having a blocked feeling in the ear with a hearing loss. Occasionally severe dizziness is experienced. When looking at the ear drum there may be greenish or bloody drainage from the hole in the drum.

A large percentage of perforations will heal with no treatment. The ones which don’t heal have usually been infected. It is very important that the patient does not get any water in the ear during the time there is a perforation in the ear drum.  The water can enter through the perforation and carry along with it the bacteria from the ear canal. The bacteria may set up an infection in the middle ear and may produce a draining ear.  Once the ear gets infected the likelihood of the perforation healing spontaneously decreases substantially.  If the perforation is caused by a diving injury and some pool water enters the ear, then the patient should be treated with antibiotics and antibiotic ear drops.  This can help prevent the development of an infection.

If the perforation does not heal then the hole should be closed surgically.  The ear surgeon does this by placing a small graft either on top of the drum or underneath the ear drum.  This operation has a very high success rate. The most important thing to remember is not to get any water in the ear.