Your child's eardrum is a thin, round membrane that separates the outer ear from the air-filled space behind it called the middle ear. The National Institutes of Health (NIH) describes a perforated, or ruptured, eardrum as a hole in that membrane, which can be caused by an ear infection.
This condition is somewhat uncommon, as most ear infections are now routinely treated, says Anne Oyler, Au.D., associate director for audiology professional practices for the American Speech-Language-Hearing Association (ASHA).
The Eustachian tube runs between the back of the nose to the middle-ear space. It opens to allow air pressure from the middle ear to equalize with the outside air pressure. An ear infection can cause pus or fluid to build up behind the eardrum. As that pressure increases, the eardrum may break open.
A child can also get a perforated eardrum from noises that are very loud and close (such as fireworks), foreign objects stuck in the ear, or being hit very hard in the ear.
"Sticking anything deeply into the ear, such as cotton swabs or hair pins, can also damage your child's fragile eardrum," says Dr. Oyler.
A buildup of pressure in your child's ear is one warning sign that her eardrum may soon rupture, according to the NIH. It's severely painful before and as it tears.
Afterwards, your child may experience:
- Drainage (may be clear, pus, or blood)
- Noise or buzzing in the ear
- Earache or ear discomfort
- Mild hearing loss
- In severe cases, weakness of the face or dizziness
If you have any concerns about your child's hearing, make an appointment with your health-care provider. Your doctor will look in the ear with an otoscope, a special microscope for the ear.
Perforations usually heal on their own within two months. If not, and the perforation is small, your physician may apply a gel or paper patch to the area to help it heal.
Some larger openings require an outpatient surgery called tympanoplasty, in which the doctor uses a small piece of your child's own tissue to close the hole.
In general, putting a warm washcloth on the painful ear can help, along with pain relievers such as ibuprofen or acetaminophen, says the NIH. You'll also need to keep your child's ear clean and dry while it's healing, so avoid the pool and place cotton balls in the ear during bathing.
"Keep the middle-ear space healthy and well ventilated by treating colds, allergies, and middle-ear infections quickly," Dr. Oyler says. If you're flying, let your child chew gum or drink water as the airplane descends. Swallowing will help the Eustachian tubes open to equalize ear pressure and avoid discomfort.
Give your child well-fitted ear protection if you know she'll be near loud noises. "Earmuffs designed for kids are best," says Dr. Oyler. Lastly, avoid sticking anything deep into your child's ear canal to avoid damaging the eardrum.
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