ear, nose, and throat disorders
Eardrum Perforation
Causes
The eardrum may be perforated (punctured) by objects inserted in the ear, such as a cotton swab, or by objects entering the ear accidentally, such as a low-hanging twig or a thrown pencil. An object that penetrates the eardrum can dislocate or fracture the chain of small bones (ossicles) that connect the eardrum to the inner ear. Pieces of the broken ossicles or the object itself may penetrate the inner ear. A blocked eustachian tube, which connects the middle ear and the back of the nose, may result in a perforation because the air pressure on either side of the eardrum is very different ( Barotrauma of the Ear ). The eardrum can also be perforated by a sudden change in pressure outside the eardrum: An increase in pressure, such as that caused by an explosion, an open-handed slap, or diving underwater A decrease in pressure, such as occurs while flying in an airplane or when strong suction is applied to the ear canal A perforation may occur when doctors irrigate the ear canal or remove a Objects in the Ear . Severe head injury may cause a perforation, particularly if the base of the skull near the ear is fractured. A middle ear infection ( Otitis Media (Acute) ) is the most common cause of eardrum perforation that is not related to an injury. 