Referral guideline – Perforated tympanic membrane


There are a number of causes of a perforated tympanic membrane including infections, trauma from a foreign object, barotrauma or head injury.

Symptoms include sudden ear pain, or sudden decrease in ear pain, discharge (which may be bloody) or hearing loss.

The vast majority of ruptured eardrums will heal without treatment.

A simple perforation of the ear drum as part of acute otitis media does NOT need referral unless it persists > 6 weeks.

GP management

  • Treatment of a perforation associated with acute otitis media is treated with oral antibiotics as per Therapeutic Guidelines
  • Non-ototoxic, topical antibiotics such as ciprofloxacin drops may be added
  • Keep ear completely dry and review in 6 weeks

When to refer

  • Refer after 6 weeks if the perforation or discharge persists

Essential referral info

  • Presenting complaint and reason for referral
  • Detailed history of the perforation
  • Patient details (name, age and gender)
  • Medicare number
  • Parent/Carer’s name and contact details
  • Referring clinician details (name, contact details, provider number, date and length of referral)

From 1 May 2019 referral criteria will apply at CHQ. This condition has minimum demographic and essential clinical referral information that is required to be included prior to submission of the referral. Visit the CPC website for the required condition. If you are unable to provide the required “essential information” please state the reason when you submit the referral.

Helpful referral info

  • Other past medical and surgical history
  • Antenatal and perinatal history that may be relevant – prematurity, birth weight, birth trauma, or alcohol/drug use in pregnancy
  • Family history
  • Current medications and allergies
  • Immunisations
  • Examination findings – including any dysmorphic features, full ocular examination
  • Is the patient of Aboriginal or Torres Strait Islander descent?

Parent service

Otolaryngology Head and Neck Surgery

Contact details

Hospital Switchboard
(Ask for Otolaryngology (ENT) On-call Registrar)
t: 07 3068 1111