What are the symptoms and treatment options for a ruptured Tympanic membrane (eardrum)?

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From the Guidelines

A ruptured Tympanic membrane typically heals on its own within 1-3 months without intervention, and initial management should focus on keeping the ear dry and managing pain with acetaminophen or ibuprofen. The symptoms of a ruptured Tympanic membrane may include ear pain, hearing loss, and drainage from the ear. It is essential to avoid using cotton swabs or inserting anything into the ear canal to prevent further irritation and infection. For patients with a ruptured Tympanic membrane, the following treatment options are available:

  • Keeping the ear dry by avoiding water entry during bathing and swimming, and using cotton balls lightly coated with petroleum jelly when showering
  • Managing pain with acetaminophen (500-1000mg every 6 hours) or ibuprofen (400-600mg every 6-8 hours)
  • Using antibiotic ear drops like ciprofloxacin/dexamethasone (4 drops twice daily for 7 days) if there's infection, as seen in cases of acute tympanostomy tube otorrhea 1
  • Oral antibiotics such as amoxicillin (500mg three times daily for 7-10 days) for more severe infections
  • Seeking immediate medical attention if severe pain, hearing loss, dizziness, or drainage from the ear occurs It is crucial to note that most perforations heal spontaneously due to the excellent blood supply and regenerative capacity of the tympanic membrane. However, large perforations or those that don't heal within 3 months may require surgical repair (tympanoplasty) to prevent recurrent infections and hearing loss.

From the Research

Symptoms of a Ruptured Tympanic Membrane (Eardrum)

  • Symptoms may include tinnitus, heaviness, and hearing loss 2
  • Patients may experience relief from symptoms such as tinnitus and heaviness after treatment 2

Treatment Options for a Ruptured Tympanic Membrane (Eardrum)

  • Treatment options may include:
    • Ofloxacin otic solution 3, 4, 5
    • Gelatin sponge patching 3, 4, 5
    • Gelfoam patching 4, 2, 5
    • Basic fibroblast growth factor (bFGF) 4
    • Trichloroacetic acid and Gelfoam 2
    • Vaseline gauze (VG) 5
  • Closure rates and closure times may vary depending on the treatment option used 3, 4, 5
  • Hearing gain may also be a factor in treatment outcomes 4, 5

Comparison of Treatment Options

  • Ofloxacin otic solution and gelatin sponge patching may be effective and inexpensive treatment strategies for traumatic large tympanic membrane perforations 3
  • Gelfoam patching and ofloxacin otic solution may accelerate the closure of human moderate and large traumatic tympanic membrane perforations 4
  • Trichloroacetic acid and Gelfoam may be used for closure of dry central type of tympanic membrane perforations 2
  • Ofloxacin ear drops and VG may be a suitable material for repairing traumatic perforation in otology clinic, which is readily available and inexpensive 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Healing Human Moderate and Large Traumatic Tympanic Membrane Perforations Using Basic Fibroblast Growth Factor, 0.3% Ofloxacin Eardrops, and Gelfoam Patching.

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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