A tympanic membrane perforation is a hole in the eardrum, the thin membrane which separates the ear canal from the middle ear. Many conditions can cause tympanic membrane perforation. Middle ear infections (otitis media) can cause pus to accumulate behind the eardrum, which if not treated quickly, can build up middle ear pressure increasing your risk for a tympanic membrane rupture. Traumatic injuries, like scuba diving, a wave slapping against your ear or insertion of a Q-tip can also cause a tympanic membrane rupture.
A hole in the tympanic membrane can cause several different complications depending on the size of the hole and its location. You may experience hearing loss due to sound not reaching the inner ear. In general, the larger the hole the more hearing loss you may experience. Ear infections can occur due to water getting into the middle ear. It is important to keep the ear dry. One technique to keep the ear dry is to place a vaseline coated cotton ball in your outer ear canal while showering. You must avoid swimming until it has healed.
If the perforation is small, it typically will heal over time. But sometimes perforations will not heal on their own and will need some form of intervention. One common method, to help to assist in healing, is to place a small paper patch over the hole which can assist the ear drum to heal naturally. If the perforation is large or has been present for over 2 months, the tympanic membrane may need to be repaired with a minor surgery called tympanoplasty. This is a routine, outpatient procedure where a small incision is made in the ear canal and the eardrum is lifted up. A small piece of material, usually a small piece of cartilage, fascia (muscle lining), or synthetic materials is then used as a graft to patch the hole. The eardrum is folded back down and some dissolvable packing is placed in the ear canal.