Acoustic trauma: Loud percussions, such as a gun going off, can cause immediate hearing loss and ringing in the ear. If the percussion is close enough and loud enough, it can actually perforate the eardrum.

Barotrauma: Rapid changes in pressure, especially in the presence of blocked eustacheon tubes, can cause pain and occasional perforation of the eardrum. Pressure changes occur when flying, scuba diving, and driving in the mountains. A common cause of sudden pressure change and a frequent cause of perforated eardrums is waterskiing. Rapid pressure changes occur when the skier falls and hits the water. Being slapped or hit on the ear can also rupture the eardrum and cause hearing loss. There can also be dizziness and ringing in the ear (tinnitus) associated with hearing loss.

Foreign bodies: Children often stick objects into their nose or ears (for unclear reasons). It is not an uncommon occurrence, with foreign bodies in the nose being more common than foreign bodies in the ear. These foreign bodies can be difficult to remove because the ear canal is basically a tube through solid bone that is lined with thin and very sensitive skin. Anything pressing against the skin, such as forceps attempting to grasp the foreign body, can cause excruciating pain.

Infection: Middle ear infections are common in childhood. It causes pain and ruined nights for the child and the parents. Infections can result in temporary loss of hearing, ringing in the ears (tinnitis), and the persistance of fluid in the middle ear. Multiple repeat infections can result in scarring or thickening of the membranes in the middle ear with gradual loss of hearing.

Any significant trauma to the ear should be evaluated by a physician. In children, the decision is often simple because the problem is usually associated with pain. Adults should seek attention if they have trauma that results in ringing (tinnitis), hearing loss, drainage from the ear, blood from the ear, pain or other problems that appear to result from trauma, or infection in the ear.

Special instruments are needed to examine the ear thoroughly, and safely remove the foreign body.

Causes

• The most common cause of a perforated eardrum is trauma, such as the deliberate or accidental insertion of an object like cotton swabs, bobby pins, or toothpicks.
• Sudden, excessive changes in pressure, such as an explosion, a blow to the head (ear), flying, scuba diving, falling while water skiing, etc.
• Earache, middle ear infection (otitis).
• Anything inserted into the ear is considered a foreign body, even when inserted with good intent. Types of objects that get lodged in the ear include inserted objects, insects, or airborne objects.

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