Typical Healing Time for a Ruptured (Perforated) Eardrum
Most traumatic tympanic membrane perforations heal spontaneously within 1-3 months, with approximately 70% healing within the first 3 months and up to 74% healing without intervention by 12 months. 1, 2
Factors Affecting Healing Time
- Small perforations typically heal faster than large perforations, with significant perforation size-dependent differences in average closure time 1
- Perforations with serosanguinous discharge heal faster (average 16 days) compared to dry perforations (average 28 days) 1
- Perforations in contact with the malleus (ear bone) have a lower frequency of spontaneous healing 3
- Large and central kidney-shaped perforations have the least tendency to heal spontaneously and often require surgical intervention 2
Healing Timeline
- Some small perforations may heal within 2-4 weeks 3
- The majority of perforations that will heal spontaneously do so within the first 3 months 2, 3
- A smaller percentage may continue healing between 3-6 months 3
- Some perforations may still heal after 6 months, particularly if signs of healing are observed within the first 6 months after injury 3
When Surgical Intervention Should Be Considered
- Perforations lasting 6-10 months after injury typically warrant surgical repair 2, 4
- Perforations in contact with the malleus may benefit from earlier surgical intervention 3
- Perforations from blast trauma, thermal or caustic injuries are less likely to heal spontaneously and may require earlier intervention 4
Complications to Monitor During Healing
- About 1-2% of patients may develop a persistent perforation that does not close on its own 5
- Some patients may develop a white mark or patch on the eardrum (sclerosis) that doesn't affect hearing 5
- A small depression or pocket in the eardrum may develop at the perforation site after healing 5
- Pre-existing tympanosclerosis (scarring of the eardrum) is the most prominent cause of healing failure 1
Follow-Up Recommendations
- Regular follow-up is important to monitor healing progress 5
- If the perforation hasn't healed after 6-10 months, surgical repair (tympanoplasty) should be considered 2, 4
- Even after apparent healing, biannual follow-up for a minimum of two years is recommended to monitor for potential cholesteatoma formation 4