Ruptured Eardrum in Children

Children are susceptible to rupture of the eardrum for several reasons. Some suffer from frequent ear infections, while others cannot resist poking things into their ear canals. Most ruptured eardrums heal quickly on their own, but you should still be aware of the symptoms and seek treatment if you suspect this condition. A ruptured eardrum requires medical evaluation. Knowing what to look for can help you decide when it is time to phone your child's doctor.

A doctor looking into a child's ear. (Image: Alexander Raths/iStock/Getty Images)

Causes

The eardrum, medically known as the tympanic membrane, serves as a thin barrier between the ear canal and middle ear. It vibrates in response to sound, transmitting sound signals from the air to the small bones within the middle ear. An ear infection can cause a buildup of fluid behind the eardrum, increasing pressure on this thin membrane. When the fluid stretches the eardrum too far, it ruptures. Trauma, such as that caused by inserting a small object into the ear canal, can also rupture the eardrum. Blunt trauma to the outside of the ear or a sudden change in air pressure -- such as occurs in an explosion, while diving or in rapid descent in an airplane -- can also cause an eardrum rupture.

Symptoms

Spontaneous rupture of the eardrum during an ear infection is rare in infants and small children, according to the textbook "Differential Diagnosis in Otorhinolaryngology: Symptoms, Syndromes, and Interdisciplinary Issues." If rupture does occur with an ear infection, your child might have a decrease in pain because of relieved pressure within the ear. You may notice a discharge of pus from the ear that could be slightly tinged with blood. Some hearing loss can occur with eardrum rupture, with greater loss of perception of low-pitched sounds. Larger perforations cause greater hearing loss. If the eardrum ruptures from trauma, sharp pain typically occurs and then subsides. Tinnitus, or ringing in the ears, can also occur.

Treatment

Antibiotics are commonly prescribed for a ruptured eardrum resulting from an acute ear infection, according to an April 2009 report in "American Family Physician." The American Academy of Pediatrics recommends antibiotic treatment for children with acute ear infection accompanied by ear drainage. If the perforation does not heal or your child experiences frequent recurrences, surgical repair of the eardrum, called a tympanoplasty, may be needed. Your pediatrician might also prescribe antibiotics to treat rupture from trauma, as the break in the eardrum increases the risk of bacteria entering the ear. Most trauma-related ruptured eardrums heal well; 68 percent heal within 1 month and 94 percent within 3 months, Stanford University School of Medicine reports.

Complications

Chronic hearing loss can result from a ruptured eardrum that does not heal properly. Ruptured eardrums that heal poorly can also lead to formation of a cholesteatoma, a growth consisting of skin cells that enters the middle ear through the perforation. Surgical removal is necessary to prevent destruction that can lead to severe hearing loss, an abscess within the skull or brain compression from the large growth. Cholesteatoma is rare in the United States.

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