Middle-ear infection
Perforated eardrum
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.
What patients notice
Common symptoms and signs
Symptoms can overlap between different ear conditions. The safest first step is a careful clinical assessment so treatment is based on what is actually seen and heard during your appointment.
- 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
Possible causes
What could be causing this?
The cause can vary from person to person. Your clinician will consider your symptoms, medical history and ear examination findings before advising on the most appropriate next step.
Ear trauma or cotton bud injury
Pressure changes
Previous ear surgery or chronic ear disease
Foreign body or instrumentation injury
How we can help
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.
Safety guidance
When to seek urgent medical advice
Most ear symptoms can be assessed in a routine appointment, but some symptoms should not wait.
- Sudden hearing loss, especially in one ear
- Severe or rapidly worsening pain
- Facial weakness, severe headache or neurological symptoms
- Marked dizziness, collapse or severe balance disturbance
- Swelling, redness or tenderness spreading around the ear
- High temperature, feeling very unwell, diabetes or reduced immune function
If symptoms are severe, rapidly worsening or concerning, please contact your GP, NHS 111, an urgent treatment centre or 999 in an emergency.
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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