Causes

Causes of a ruptured (perforated) eardrum may include:

• Middle ear infection (otitis media). A middle ear infection often results in the accumulation of fluids in your middle ear. Pressure from these fluids can cause the eardrum to rupture.

• Barotrauma. Barotrauma is stress exerted on your eardrum when the air pressure in your middle ear and the air pressure in the environment are out of balance. If the pressure is severe, your eardrum can rupture. Barotrauma is most often caused by air pressure changes associated with air travel.

  Other events that can cause sudden changes in pressure — and possibly a ruptured eardrum — include scuba diving and a direct blow to the ear, such as the impact of an automobile air bag.

• Loud sounds or blasts (acoustic trauma). A loud sound or blast, as from an explosion or gunshot — essentially an overpowering sound wave — can rarely cause a tear in your eardrum.
• Foreign objects in your ear. Small objects, such as a cotton swab or hairpin, can puncture or tear the eardrum.
• Severe head trauma. Severe injury, such as a skull base fracture, may cause the dislocation of or damage to middle and inner ear structures, including your eardrum.