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stephanie94911 stephanie94911

When a ruptured eardrum bleeds, where is the blood coming from?

Does anyone know this? I'm sure the thin, delicate eardrum itself isn't bleeding, right? So when someone suffers a ruptured eardrum, whether from infection or trauma, where is the blood actually coming from? I don't get it!

6 Replies

  • pistal666 pistal666 stephanie94911

    Hi Stephanie, A ruptured Eardrum is going to bleed. Whilst the Eardrum is very thin (about 0.1mm), it is covered with a thin layer of skin and does carry a blood supply. Think of inside your nose, its kinda like a much thinner version of your septum. Hope this helps smile Al

  • ENTdoc ENTdoc stephanie94911

    No mystery here....

    Yes, the blood comes from the eardrum.  It has small blood vessels through which it received its nourishment.  The eardrum has 3 layers, a middle fibrous layer, a middle ear mucosal layer, and an external layer of squamous epithelium (similar to skin but much thinner).  The fibrous layer is the thickest.  

    In the case of trauma, such as from use of Q tips, it is more common for the thin skin of the ear canal to be the source of bleeding, although puncture of the eardrum is also seen less frequently than canal trauma.

    • stephanie94911 stephanie94911 ENTdoc

      Thank you for the info! I suffered both an eardrum perforation and an ear canal laceration as the result of a zip pull going into my ear. My ear didn't bleed profusely but I started to feel blood beading up in my ear canal a couple hours later.

      I went to the ER and was given Neomycin/Polymyxin B ear drops. I used them one time (3 drops) and then read they shouldn't be used in place of a perforation so of course I didn't use them again. My ear was still bleeding the next morning. I then developed tinnitus the following day.

      Do you know.. Is there a risk of ototoxicity from either the 3 drops entering my middle/inner ear through the perforation AND/OR a risk of ototoxicity from the neomycin drops absorbing into my bleeding ear canal laceration? I've read so many horror stories about people going deaf over several months, with tinnitus as a first symptom, after using neomycin as a wound irrigant and now I'm so worried that I will lose my hearing. Granted, the cases I've read were caused by much larger amounts of drug, but I can't stop worrying. I've had constant tinnitus for 3 months now.

    • ENTdoc ENTdoc stephanie94911

      There is no need for you to use anabiotic drops or take oral antibiotics in the absence of infection. There is no way one dose or even a few doses of topical antibiotic ear drops will damage hearing.

      Study show that your exams by general practitioners resultant incorrect diagnosis and incorrect treatment more than 60% of the time. Adequate exam of an ear canal with blood in it requires the use of a binocular microscope, which emergency rooms never have. Nor would they have the other instruments or training required to use it even if they had the microscope. You need an exam by an ENT physician if you want to know the exact nature of your injury. If, with your nose pinched off and your mouth closed, you can blow air through your eustachian tube to inflate the middle ear and not hear air escaping from the ear canal, then it would be extremely unlikely that you have a perforated eardrum. Feeling the ear inflate (often described as a popping sensation) confirms the eardrum as intact. In the great majority of cases of foreign bodies entering the ear canal, the canal skin is traumatized, but not the eardrum. This is partially because the ear canal is not straight. Infection seldom occurs from trauma to the ear canal. The only precaution you need to take is to keep water out of your ear until it heals, which ear canal lacerations do, with no treatment. The water avoidance is in case you do have a perforation of your eardrum, as it might lead to infection in the middle ear. Even if you have a hole in your eardrum, the great majority heal with no residual effect.

    • stephanie94911 stephanie94911 ENTdoc

      Thank you! I did see an ENT as soon as I could, which was a few days later, and he confirmed the eardrum perforation. Like you, he said I did not need eardrops though I had already stopped taking them before I saw him. My eardrum has since healed (as seen by the ENT) but I still have scabbing in my ear canal.

      Since one dose of drops isn't enough to damage my inner ear, do you have any ideas on what could cause tinnitus in this case? My ENT originally said it was probably from the perforation but since it's healed and the tinnitus remains, he's just not sure anymore. It started (in both ears/in my head) about 24 hours after the injury and using the drops. Can bilateral or central in the head tinnitus result from an eardrum perforation and remain after the eardrum has healed? It's high pitched and I can hear it over the tv, fan, etc and is 24/7. I've never had this problem until right after the perforation. My hearing tests were considering "great" and within normal range (it's been tested 3 times now).

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