Anatomy of the Eardrum

The tympanic membrane, commonly known as the eardrum, is a thin layer of skin stretched tight, like a drum, in the ear. The eardrum separates the outer ear from the middle ear and vibrates in response to soundwaves.

The eardrum is part of a complex system involved in the hearing process. It also protects the middle ear from debris and bacteria.

Sometimes an infection may cause the eardrum to rupture. Symptoms of a ruptured eardrum include hearing loss, ear pain, itching, and fluid draining from the ear. Usually, eardrums that rupture heal on their own.

Anatomy

The eardrum has three layers: the outer layer, inner layer, and middle layer. The middle layer is made of fibers that give the eardrum elasticity and stiffness. Cartilage holds the eardrum in place.

The eardrum covers the end of the external ear canal and looks like a flattened cone with its tip pointed inward toward the middle ear. It is transparent and is about the size of a dime.

The eardrum divides the outer ear from the middle ear. The eardrum sits between the end of the external ear canal and the auditory ossicles, which are three tiny bones in the middle ear, called the malleus, incus, and stapes.

Function 

The two primary functions of the eardrum are auditory and protective.

Auditory

As soundwaves enter the ear canal, they hit the eardrum, causing it to vibrate. These vibrations then move the three tiny bones in the middle ear.

Those bones then increase the sound and send them to the cochlea in the inner ear, where hair cells ripple and an electrical signal is created. From there, an auditory nerve carries the signal to the brain, where it is received as sound.

Protective

In addition to helping you hear, the eardrum also acts as a protective barrier, keeping the middle ear free from dirt, debris, and bacteria. If an eardrum becomes perforated or ruptures, the middle ear is vulnerable to infection.

Associated Conditions 

The eardrum is delicate and can rupture or tear. Most often this happens as a result of a middle ear infection (called otitis media). Damage to the eardrum can also occur as a result of trauma from things like:

• Injury from hitting the eardrum with an object, such as a cotton swab
• Loud noises
• Head injury
• Changes in air pressure

When an eardrum ruptures, you may notice hearing loss or muffled hearing, pain in the ear, and/or drainage from the ear. 

Pain from a ruptured eardrum is often treated with over the counter pain relievers. A warm compress held on the outside of the ear may also offer some relief. If the rupture is due to a middle ear infection, your healthcare provider will likely prescribe antibiotics to treat the infection. 

It is important not to put anything in the ear if you have or suspect you may have a ruptured eardrum. 

Tests 

A ruptured eardrum can be seen with an otoscope, an instrument used to look into the ears. Many times a healthcare provider can diagnose a ruptured eardrum by simply looking in the ear.

If looking at your eardrum with an otoscope is not conclusive, your healthcare provider may also do an audiology exam to test your hearing. In addition, they may perform tympanometry, which tests how your eardrums respond to pressure changes.

Most ruptured eardrums heal on their own within a few weeks, though it can take longer. Rarely, ruptured eardrums require surgery to repair.

Surgical eardrum repair is performed by an ear, nose, throat (ENT) surgeon under general anesthesia. There are two types of surgical repair: patch myringoplasty and tympanoplasty.

Patch myringoplasty is the shortest and simplest procedure. In patch myringoplasty, paper or gel is used to temporarily cover the hole in the eardrum, prompting the body to close the hole on its own. One study that compared material used in the procedure found that there was no significant difference in closure rates based on which material was used.

Tympanoplasty is a more common and also more involved procedure. During a tympanoplasty, a surgeon uses fascia to replace the missing portion of the eardrum.