Having a burst eardrum is usually very painful. This is because the drum is very sensitive and contains many nerve fibres. These are triggered to fire when the drum tears.
The causes of a burst eardrum are usually related to a change in pressure. These include flying in an aeroplane, scuba-diving and explosions such as a bomb blast. Ear drum bursting is much more common if somebody has Eustachian tube dysfunction. In this condition the Eustachian tube is blocked. It does not let the pressure in the middle ear equalise with that of the outside world. This is important if the outside pressure is changing.
For instance if you go up in an aeroplane or climb a mountain. Usually, as the pressure drops air travels from the middle ear space to the outside world through the tube. If this tube is blocked then the pressure in the middle ear builds up, resulting in pain as the eardrum stretches. Sometimes if the pressure gradient is high enough across the drum then the eardrum bursts. Treatment of the Eustachian tube dysfunction can help to prevent this happening. Causes include having a cold, tonsillitis or another cause of inflammation at the back of the throat.
Wearing earplugs when exposed to high pressure can help prevent the drums from bursting. Unfortunately most people do not have much warning of a bomb blowing up but you can always wear plugs in aeroplanes. It is not recommended to wear ear plugs when scuba-diving as this creates an area which cannot be equalised. This makes rupture of the drum more likely.
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