Symptoms of a Ruptured Tympanic Membrane
A ruptured eardrum typically presents with sudden ear pain followed by relief, hearing loss, tinnitus, and sometimes bloody or clear drainage from the ear canal. 1
Primary Symptoms
- Sudden sharp ear pain that often improves immediately after the perforation occurs, as the pressure is released 1
- Hearing loss ranging from mild to moderate (typically a conductive loss of less than 30 dB in uncomplicated cases) 1
- Aural fullness or a sensation of blockage in the affected ear 1
- Tinnitus (ringing or buzzing in the ear) 1
- Bloody or clear drainage from the ear canal, which may be the first visible sign of perforation 2
Symptoms Suggesting Complications
- Vertigo, nausea, and vomiting indicate possible disruption of the ossicular chain or inner ear involvement 1
- Profound sensorineural hearing loss (greater than 30 dB conductive loss) may signify inner ear nerve damage or ossicular chain disruption 1
- Persistent or worsening pain after the initial injury suggests secondary infection 1
Important Clinical Context
The mechanism of injury influences symptom presentation. Perforations from acute otitis media typically present with severe ear pain that suddenly resolves when the drum ruptures and pus drains. 3 Traumatic perforations from penetrating injuries, blast injuries, or sudden pressure changes (such as during Valsalva maneuvers in labor) may present with immediate hearing loss and blood in the canal. 2, 4
Many small perforations may be asymptomatic or cause only minimal symptoms, particularly if discovered incidentally during examination. 1 However, even asymptomatic perforations require proper management to prevent infection and ensure healing. 5