What should I do if I have tinnitus due to a perforated eardrum?

Recently, a friend developed a tympanic membrane perforation accompanied by tinnitus, and would like to consult on appropriate treatment options. So, what should be done for tinnitus associated with tympanic membrane perforation?

What to Do for Tinnitus Associated with Tympanic Membrane Perforation

Tinnitus resulting from tympanic membrane perforation can be temporarily alleviated using medications that improve microcirculation and nourish the auditory nerve. Commonly prescribed medications include ginkgo biloba extract tablets and mecobalamin dispersible tablets. After perforation, water must be strictly prevented from entering the external auditory canal to avoid infection—such as otitis externa with purulent discharge—which may further exacerbate tinnitus. Small tympanic membrane perforations typically heal spontaneously within 1–3 months, and associated tinnitus usually resolves during this period. However, large perforations generally do not heal on their own and require surgical intervention: tympanoplasty (tympanic membrane repair) under general anesthesia at a hospital.

The primary adverse effect of tinnitus associated with tympanic membrane perforation is hearing loss—specifically conductive hearing loss. If tympanoplasty is not performed, this hearing impairment persists, adversely affecting the patient’s daily communication and overall quality of life.

Following tympanic membrane perforation, the middle ear cavity becomes directly exposed to the external environment. Consequently, pathogens—including viruses and bacteria—as well as foreign contaminants such as insects or water may enter the middle ear through the perforation, potentially triggering otitis media. Early manifestations often include acute suppurative otitis media. With recurrent or chronic inflammation, granulomatous otitis media or cholesteatoma may develop. Over time, these conditions may progress to chronic suppurative otitis media, progressive hearing loss, and even intracranial or extracranial complications. We hope this information proves helpful!