Perforated eardrum in children, when it happens and how to recognise it

A perforation of the tympanic membrane is the result of a traumatic rupture of the eardrum, a delicate structure that separates the outer ear from the middle ear. This thin layer of tissue plays an essential role not only in ensuring adequate transmission of sound waves for proper functioning of the auditory organ, but also in maintaining the individual's balance.

It is an event that compromises auditory function and can affect the overall sensory perception of the surrounding environment.

What happens to children?

Earaches are common among children and are often caused by otitis, an infection that can be viral or bacterial in origin. This condition can lead to severe pain and crying in the child, along with irritability, loss of appetite and other symptoms. In more severe cases of acute otitis, the eardrum may be damaged. However, it is important not to be alarmed and to promptly act with appropriate treatment, as the lesion tends to heal within a few weeks without leaving permanent marks. Nevertheless, it is essential not to ignore the warning signs and to treat this condition promptly.

Perforated eardrum in children: causes

What causes eardrum perforation in children?

The eardrum not only helps protect the inner ear from bacteria, but also transmits sound inside it. When a child has a perforation of the eardrum, hearing can be compromised, as the normal process of sound transmission is disturbed.

In children, perforation of the eardrum is often a complication of otitis, which, by producing inflammation, may cause pus to form in the middle ear. This accumulation of pus can exert increasing pressure on the eardrum, causing it to rupture in severe cases.

In addition to otitis, perforation can be caused by other events such as:

• Sudden changes in pressure (such as a slap or an explosion): if the eardrum is suddenly subjected to a drastic change in pressure, for example during a sudden blow such as a slap or due to a nearby explosion, it may not be able to adapt quickly and therefore rupture.
• Head trauma: If a child suffers a head injury, such as a fall or a blow to the head, the force of the impact may cause the eardrum to rupture.
• Accidental introduction of foreign objects into the ear: it is quite common for children, especially young children, to introduce objects such as cotton buds or small parts of toys into the ear. These objects can damage the eardrum if they are pushed too deeply or handled roughly.

Perforated eardrum in children: symptoms

In children, it is important to pay attention to some alarm bells that could suggest the presence of otitis and perforation of the eardrum:

• Very high fever.
• Balance problems and dizziness.
• Constant rubbing of the ear.
• Lack of appetite.
• Symptoms of colds (catarrh, cough, colds).
• Night restlessness.
• Irritability.

Children with a perforated eardrum may also experience:

• Lowered hearing and a sense of muffling, the severity of which will depend on the size of the perforation and the possible damage to the chain of ossicles, which are located inside the tympanic cavity.
• Tinnitus: perception of a buzzing sound inside the ear.
• Sudden ear pain: if the perforation occurs suddenly, it may cause pain.

Perforated eardrum in children: consequences

A perforated eardrum can cause a lot of discomfort, but if the lesion is small it heals spontaneously, without specific treatment, within a couple of months. Moreover, the reduction in hearing ability is usually temporary and depends on the location and size of the perforation. Children, as well as adults, must also make an effort during the period of infection to:

• Avoid introducing objects or liquids into the ear.
• Avoid contact with water.
• Avoid blowing the nose too hard.

No ear hygiene products should be used during acute otitis or inflammation; only when the situation has resolved is it advisable to maintain a thorough cleaning of the ear canal using gentle products that can help promote the well-being of the ear.

When there is a suspicion of a perforated eardrum, it is in any case important to contact a specialist as soon as possible to find the most appropriate solution: if all goes well, the eardrum heals within a few weeks and only in very rare cases it may be necessary to recur to reconstruction surgery.