A perforated or "ruptured" eardrum in children is a hole or tear in the eardrum. The eardrum is the membrane that separates the ear canal from the middle ear. Some perforations are preventable, while others can result from normal childhood illnesses. Knowing the signs and proper treatment of a perforated eardrum can help you make your child comfortable while her ear heals.
The most common causes of perforated eardrums in children are middle ear infections and foreign body trauma. In a middle ear infection, fluid builds up behind the eardrum. If the pressure becomes severe, the eardrum will perforate. Foreign body trauma often results from placing Q-tips, sticks or other sharp objects in the ear canal. Other causes of perforated eardrums include: extremely loud sounds, head injuries and pressure changes, such as those caused by aeroplane rides.
A child with a middle ear infection who has perforated his eardrum will experience sudden pain relief as a result of decreased pressure behind the eardrum. You may notice clear fluid that is tinged with blood or pus draining from your child's ear canal. A child with a perforated eardrum may experience nausea, vomiting and vertigo. Hearing loss also is a symptom of a perforated eardrum.
Most perforated eardrums heal on their own. Those that do not may require a paper patch. A paper patch is a small patch that is placed over the tear in the eardrum. This can be done in an ENT physician's office. If a paper patch fails, your child may require a tympanoplasty, where the surgeon will graft skin from another part of your child's body and use it to patch the hole in his eardrum.
Infection and hearing loss are the two most common complications of a perforated eardrum in children. Infections are treated easily with antibiotics; some physicians also prescribe antibiotics to prevent an infection. Hearing loss is determined by the severity of the tear in the eardrum. Most hearing loss disappears after the tear has healed.
Never use Q-tips to clean your child's ear. Use just a washcloth and your finger. Even safety Q-tips can be dangerous (the stick can come through the cotton).
Keep your child's ear dry during the healing process.
Give the entire course of antibiotics as recommended to treat and prevent infection--if your child does not show symptoms.