A head injury or an ear slap can cause the eardrum to rupture. So can an acoustic trauma caused by a sudden loud noise, such as an explosion or a sudden blast of loud music.

Some ruptured eardrums result from what's known as barotrauma. This happens when the pressure inside the ear and the pressure outside the ear are not equal. That can happen, for example, when an airplane changes altitude, causing the air pressure in the cabin to drop or rise. The change in pressure is also a common problem for scuba divers.

Some people don't notice any symptoms of a ruptured eardrum. Others see their doctor only after several days of general discomfort in their ear and feeling that "something's not quite right with the ear." Some people are surprised to hear air coming out their ear when they blow their nose. Forcefully blowing your nose causes air to rise up to fill the space in your middle ear. Normally this will cause the eardrum to balloon outward. But if there is a hole in the eardrum, air will rush out. Sometimes the sound is loud enough for other people to hear.

How Is a Ruptured Eardrum Diagnosed?

If you have any of the symptoms of a ruptured eardrum, the doctor will do an otoscopic exam. An otoscope is an instrument with a light that's used to look inside the ear. In most cases, if there is a hole or tear in the eardrum, the doctor will be able to see it.

Sometimes there may be too much wax or drainage for the doctor to clearly see the eardrum. If this is the case, the doctor may clean the ear canal or prescribe eardrops for you to use to help clear it. Sometimes, the doctor uses a rubber bulb attached to the otoscope to blow a puff of air into the ear. If the eardrum is not ruptured, it will move when the air hits it. If it is ruptured, it won't.

The doctor may also test your hearing to determine how much effect the ruptured eardrum has had on your hearing; he or she may use a tuning fork to test it. The doctor may also ask for an audiology test, which uses a series of tones you listen to with headphones to determine your level of hearing. Most hearing loss due to a ruptured eardrum is temporary. Normal hearing returns usually after the eardrum heals.