Middle-ear infection
Perforated Eardrum Symptoms and Assessment
A perforated eardrum is a hole or tear in the tympanic membrane. It may follow infection, trauma, pressure change or ear instrumentation. Symptoms vary and some people may not realise the eardrum is affected.
Common symptoms and signs
Symptoms can overlap between different ear conditions. A careful clinical assessment helps ensure treatment is guided by your symptoms, clinical history and examination findings.
- Hearing change or muffled hearing
- Discharge after ear infection
- Pain that changes or settles after discharge
- Whistling sounds or air sensation
- Sensitivity to water in the ear
Common ear-related causes
A perforated eardrum may be linked to infection, trauma, pressure change, previous ear surgery or an injury from an object in the ear canal. Examination helps confirm whether the eardrum can be seen clearly and whether further care is needed.
Ear trauma or cotton bud injury
Pressure changes
Previous ear surgery or chronic ear disease
Foreign body or instrumentation injury
Doctor-led assessment at Nottingham Ear Clinic
Your doctor can examine the eardrum and advise whether findings suggest perforation, infection, scarring or another eardrum concern. Advice may include water precautions, treatment, monitoring or onward ENT care.
When to seek urgent medical advice
Most ear symptoms can be assessed in a routine appointment, but some warning symptoms should not wait.
- Sudden hearing loss, especially in one ear
- Severe or rapidly worsening pain
- Facial weakness, confusion or severe headache
- Marked dizziness, collapse or severe balance disturbance
- Swelling, redness or tenderness spreading around the ear
- High temperature or feeling very unwell, particularly if you have diabetes or reduced immune function
If symptoms are severe, rapidly worsening or concerning, seek advice from your GP, NHS 111, an urgent treatment centre or 999 in an emergency.
Related ear care services
Private ENT Consultation
Doctor-led assessment for ear pain, discharge, tinnitus, dizziness and complex ear symptoms.
Microsuction Wax Removal
Safe, precise ear wax removal where wax is present and treatment is clinically appropriate.
Ear Infection Treatment
Assessment and treatment advice for painful, itchy, inflamed or discharging ears.
Private Hearing Care
Ear and hearing health checks with access to full hearing assessments from experienced audiologists.
Tinnitus Management
Assessment and support for ringing, buzzing, humming or whooshing sounds.
Hearing Protection
Custom hearing protection, ear impressions and advice for noise exposure.
Frequently asked questions
Helpful answers about perforated eardrum and when to book an appointment.
Can you diagnose a perforated eardrum?
A doctor can examine the eardrum and advise whether a perforation or other eardrum change is visible.
Should I keep my ear dry?
If a perforation is suspected or confirmed, water precautions are often advised. Your clinician will explain what is appropriate for your situation.
Can microsuction be done with a perforated eardrum?
It depends on the clinical findings and risk assessment. Treatment will only be offered if considered safe and appropriate.
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