Causes of a Bulging Eardrum and Treatment Options - Verywell Health

A bulging eardrum is an inflamed tympanic membrane. The tympanic membrane, also called the eardrum, is a thin flap of skin in the ear over the ear canal. When sound enters the ear, the eardrum vibrates. This vibration moves the tiny bones in the middle ear, sending sounds into the inner ear.

A bulging eardrum can be caused by many different things, such as an ear infection. It can affect hearing because it impairs the eardrum's ability to vibrate and transmit sound. When the eardrum is inflamed, it can cause a person to experience fullness in their ear, ear pain, and pressure.

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Symptoms

Symptoms that may occur along with a bulging eardrum include:

• Pain in the affected ear or ears
• Fullness in the ear caused by trapped fluid behind the eardrum
• Temporary hearing loss
• Fever

In children who have a bulging eardrum and are pulling their ears, they may be unable to sleep and irritable.

Causes

A bulging eardrum is usually a symptom of a condition that affects the ear. Several health conditions can cause the eardrum to become inflamed and bulge.

Middle Ear Infections

Middle ear infections, also known as otitis media, are the most common type of ear infection. Although children are most often affected by middle ear infections, they can occur at any age.

A middle ear infection develops because bacteria, germs, or viruses in the mouth, nasal passages, or eyes made their way into the ear and became trapped behind the eardrum. The buildup of fluids behind the eardrum and in the middle ear causes it to become inflamed and irritated.

When this happens, you may also have ear pain and plugged ears. Hearing loss can also occur. Acute otitis media is the first stage of the infection and presents with the typical symptoms of an ear infection. Otitis media with effusion, on the other hand, occurs after the infection has gone away, but there is still a buildup of mucus or fluid that no longer contains bacteria.

Ear Trauma

The eardrum is a sensitive part of the body. It's thin and pliable, so it can be easily damaged. Any foreign object in the ear can lead to injury of the eardrum, such as a cotton swab, finger, or even earbud headphones.

Other types of trauma that can lead to a bulging eardrum include:

• Acoustic trauma: This occurs when someone is exposed to extremely loud noises. The noise can be a single loud blast or continuous sound over a long period of time. Acoustic trauma can damage the eardrum, but it is unusual for it to cause a bulging eardrum.
• Head injury: Injuries to the head can lead to a bulging eardrum if bleeding occurs in the ear. If blood gets trapped behind the eardrum or in the ear canal, which connects the outer and middle ear, it can lead to a bulging eardrum and bruising.
• Barotrauma: Barotrauma is caused by changes in air or water pressure in the ear. This can occur during a flight, scuba diving, or at changing altitudes. The eustachian tube, a canal in the ear that regulates pressure in the ear, can become blocked during barotrauma. When this happens, the eustachian tube cannot maintain pressure and this causes a bulging eardrum.

Bullous Myringitis

Bullous myringitis is a type of ear infection that causes small blisters to form on the eardrum. It can be caused by viruses and bacteria, and may present with symptoms such as severe pain, ear discharge, and hearing loss.

Bullous myringitis often occurs at the same time as a middle ear infection. When a person has this type of infection, fluid can become trapped behind the eardrum and cause it to bulge.

Swimmer's Ear

Swimmer's ear, medically known as otitis externa, is a type of ear infection that affects the outer ear and ear canal. It occurs when water becomes trapped in the ear, allowing bacteria to grow and cause an infection. Although a case of swimmer's ear can occur at any age, it is most commonly seen in children.

The symptoms associated with swimmer's ear include:

• Ear pain
• Itching inside the ear
• Pus with a foul odor from the ear
• Blocked ear
• Redness and swelling
• Temporary hearing loss
• Slight fever

Swimmer's ear can cause the eardrum to bulge if the infection spreads down the ear canal and the eardrum becomes inflamed due to the buildup of pus.

Typically, a bulging eardrum is caused by another health condition. Most of the conditions that can cause it to occur are mild or moderate in nature and easily treatable.

When to See a Doctor

The symptoms associated with a bulging eardrum are typically present because there is some type of infection or injury. To be on the safe side, if you have a bulging eardrum, you should make an appointment with your physician. They will be able to determine what is causing it and develop a course of treatment specific to your condition.

Diagnosis

Diagnosing a bulging eardrum is based on the condition that is causing it. Doctors will likely determine what the condition is using symptoms as a baseline.

Middle Ear Infections

To diagnose a middle ear infection, your physician will take a medical history and ask about the symptoms you are experiencing. They will then examine your eardrum using a small lighted instrument known as an otoscope.

Inflammation of the eardrum and fluid buildup will help them determine if you have an ear infection. If there is a fluid or mucus buildup, your doctor may also take a sample of it to determine what type of bacteria or virus is causing your infection.

Ear Infection Doctor Discussion Guide

Ear Trauma

If you have a head injury or there is a foreign object in your ear, your physician can likely determine the cause by examining you. They will likely use an otoscope to check the extent of the damage to the eardrum.

Bullous Myringitis

Bullous myringitis is diagnosed similarly to a middle ear infection. Your physician will ask about your health history and your symptoms. They will then perform a physical exam.

The findings of both a middle ear infection and bullous myringitis are similar, but they may order more tests if bullous myringitis is suspected. Your physician will need to examine your eardrum for blisters.

Swimmer's Ear

The initial diagnostic process for swimmer's ear will be similar to that of an ear infection. A doctor will ask about your symptoms and health history. They will also likely ask whether you swim regularly.

They will then use an otoscope to examine your ear canal. You likely have swimmer's ear if the canal has signs of swimmer's ear such as redness, flakiness, or scaling and the eardrum is bulging.

If further testing is required, your physician may take a sample of the pus draining from your ear to have it sent to a lab for testing.

Can a Bulging Eardrum Lead to a Rupture?

If the condition that is causing your eardrum to bulge persists, your eardrum may rupture. This is why it's important to seek medical care right away if you have a bulging eardrum.

Treatment

Treatment depends on what's causing your bulging eardrum. In the event that your bulging eardrum is caused by trauma, treatment options will vary depending on the type and severity. In most cases, trauma to the ear will heal on its own. This is also the case with some ear infections, but others may require the use of medications.

Middle ear infections are often left to heal on their own because up to 80% of cases end up going away without antibiotics. The other 20% of cases require antibiotic treatment. Many physicians will treat almost all middle ear infections with oral antibiotics.

Bullous myringitis is typically treated with antibiotics, but may also require the blisters to be lanced off of the eardrum. Swimmer's ear is commonly treated with a combination of medications, which may include antifungals, antibiotics, and steroids.

Over-the-counter medications, such as ibuprofen, can help relieve inflammation and pain.

There are things you can do to help with your other symptoms such as pain while you recover. You could put a warm compress on the affected ear or perform a few neck exercises. These exercises may help relieve any pressure within the ear.

Prevention

While it may be hard to avoid certain infections that can cause a bulging eardrum, there are things you can do to help reduce the risk.

Middle Ear Infections

Sometimes a middle ear infection can be hard to prevent. There are, however, ways you can lower your risk of contracting an ear infection, including:

• Quit smoking.
• Control allergies with medications or reduce allergens in the home.
• Prevent catching a cold by avoiding the sharing of cups, toys, food, or utensils and washing your hands regularly.
• Breastfeed your baby for the first 12 months of their life.
• When feeding your baby with a bottle, do so at an upright angle to prevent fluids from going into their ear.
• Get all your vaccinations.

Ear Trauma

Some ear traumas are unavoidable, especially a head injury. Other types of ear trauma, however, can be prevented. Things you can do include:

• Never put anything in your ears, including cotton swabs or fingers.
• Avoid places with excessively loud noise that could damage the eardrum.
• Keep volume low on headphones or speakers in the car.
• Wear ear protection at concerts or other events with loud noises.
• Wear a snug-fitting helmet while riding your bike, skateboarding, or skating.
• Use protective head equipment when playing sports.

Bullous Myringitis

Preventing bullous myringitis is similar to preventing middle ear infections because they are both caused by bacteria or viruses caught from other people. To help prevent the development of bullous myringitis, you can:

• Avoid smoking.
• Avoid touching your mouth, nose, or eyes if you haven't washed your hands.
• Wash your hands regularly to keep them clean.

Swimmer's Ear

Swimmer's ear may be difficult to prevent for avid swimmers, but it's not impossible. According to the Centers for Disease Control and Prevention, preventing swimmer's ear can be done by introducing some hygiene practices following swimming, such as:

• Keeping your ears as dry as possible by using a swim cap, earplugs, or swim molds while swimming
• Drying ears thoroughly after swimming using a dry towel
• Turning your head back and forth while pulling on the earlobes to allow water that's in the ear canal the chance to flow out
• Using a hairdryer on a low setting to dry your ear canal (never use a hairdryer on a medium or high heat setting since this may burn the outer ear)
• Talking to your doctor about using drying ear drops (this can be especially helpful if you suffer from recurrent episodes of swimmer's ear)
• Leaving some earwax in your ear to help prevent infection
• Avoiding putting objects such as cotton swabs into your ears

Summary

A bulging eardrum has many causes, from injury to ear infections. Prolonged bulging of the eardrum can potentially lead to eardrum rupture or hearing loss. If you have a bulging eardrum, talk to your doctor so they can identify the cause and help you manage your symptoms.

A Word From Verywell 

A bulging eardrum can be a painful experience and difficult to cope with. The good news is that the majority of conditions that cause the eardrum to bulge are mild and easily treatable. Some may not require treatment at all.

If you are experiencing any symptoms with a bulging eardrum, call your doctor. They can help you address your symptoms and treat the cause efficiently.