Definition
The eardrum is a thin, flat membrane that separates the outer ear from the middle ear. It completely seals these two structures from each other. If the continuity of the eardrum is interrupted, the eardrum is called a torn eardrum. Visually, the physician then sees a hole in this structure when inspecting the eardrum.
Causes
The cause of a ruptured eardrum is always an overuse of its elasticity. It does not matter whether it is a cotton swab that is pressed too hard against the eardrum when cleaning the ear canal or a blow to the ear that causes a strong pressure wave towards the middle ear. If the force acting on the eardrum is too great, it cannot be deflected further in one direction and tears.
When flying, it is the increasing air pressure in the cabin during landing that causes a suction effect in the middle ear. In a diving accident, it is the ambient pressure that decreases too rapidly during ascent that leads to an increase in volume in the middle ear. Any excessive pressure that cannot be equalized in time causes the paper-thin membrane to rupture due to the tension.
Even an effusion in the middle ear can lead to a rupture due to the weight of the accumulated fluid. The rupture itself can be seen as relief in the case of an effusion. Any excessive pressure emanating from the middle ear could destroy structures in the middle ear and thus affect hearing ability.
A hole in the eardrum allows the ossicles to balance and thus to be spared. The tearing caused by excessive external pressure serves as a buffer. The air or the foreign body should not pass unhindered through the ear structures and possibly manipulate the ossicles in their anchoring. The eardrum therefore absorbs the most severe and serves as a warning function, as its tearing causes severe pain. At the latest then the affected person should notice that he should turn his head away or remove a foreign body.
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