What Is a Retracted Eardrum (Tympanic Membrane Retraction)?

Written by Marijke Vroomen Durning, RN
Medically Reviewed by Jabeen Begum, MD on July 30, 2025
8 min read

A tympanic membrane retraction, or retracted eardrum, is a condition in which the eardrum gets pulled toward the middle of your ear. The eardrum, also called the tympanic membrane, is a thin layer of tissue between your inner and outer ear. It’s responsible for sending sound vibrations to the bones in the middle ear so you can hear.

A retracted eardrum is pretty common. “We see complaints of ear fullness and retracted eardrums frequently in our clinic,” says Rachel A. Raphael, an audiologist at Ear, Nose, & Throat Baltimore at Mercy Medical Center in Baltimore.

One of the leading causes of a retracted eardrum is eustachian tube dysfunction. Your middle ear is usually filled with nothing but air. Air pressure outside the eardrum should remain equal to that in your middle ear. If an eustachian tube issue changes that balance, it can create a vacuum that pulls your eardrum toward your middle ear. A vacuum can also form because of an infection caused by bacteria in the eustachian tube.‌

Rapid changes in air pressure can also lead to a retracted eardrum. Sometimes, only parts of the eardrum are affected, forming small retraction pockets.

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There are four stages of eardrum retraction:

  • Level 1 retraction: There’s retraction of the eardrum, but it doesn’t touch any of the bones of the middle ear.
  • Level 2 retraction: The tympanic membrane touches the middle ear bones.
  • Level 3 retraction: The middle ear cavity starts to narrow because of the retracted eardrum.
  • Level 4 retraction: The retracted eardrum gets stuck in the middle ear space because of long-term (chronic) inflammation.

Some people don’t notice any symptoms from a retracted eardrum. Others may have chronic issues as the eardrum presses on the tiny bones inside the ear. If left untreated, pressure can build up in the middle ear. You may have:

  • Pain in your ear
  • A feeling of pressure or fullness in your ear, such as what you might feel when the pressure changes in an airplane
  • Hearing loss, which can be temporary or permanent
  • Fluid or drainage in your ear

Can a retracted eardrum cause dizziness?

You may feel dizzy if you have a retracted eardrum. But it’s not the tympanic membrane retraction that causes the dizziness — it’s the pressure in your ear.

A doctor or a specialist such as an otolaryngologist (ENT) can easily diagnose a retracted eardrum. They may ask you questions about your symptoms and any ear conditions you have.

 “Tympanometry or immittance testing is a routine and quick test I do on every patient as part of the comprehensive audiological evaluation process,” Raphael says.

A tympanometer is an instrument that the doctor will put in your ear canal. Your provider will use the device to change the air pressure in your ear canal. The tool sends out a tone and measures how well your eardrum moves in response to the stimulation.

Without treatment, a retracted eardrum could lead to a ruptured, or torn, eardrum. Signs of a ruptured eardrum include ringing in your ear and nausea from vertigo. Contact a doctor immediately if you think you have a ruptured eardrum or have persistent issues with your ears.‌

A ruptured eardrum may heal without treatment. If it doesn’t heal within six months, you may start having complications, including hearing loss. This typically lasts until the rupture heals. How much your hearing is affected depends on the size and location of your rupture. You may also find yourself dealing with chronic ear infections because bacteria continually make their way inside the tear in your eardrum.

Another complication that could develop is a cholesteatoma, a cyst that forms in the eardrum retraction pocket. It starts as a buildup of skin and earwax, then spreads to the middle ear or the mastoid bone behind the ear. The eardrum usually sheds dead skin into the ear canal, which is what causes wax buildup. It’s not able to do this if it collapses, leading to a cholesteatoma.

Signs of a cholesteatoma resemble those of a ruptured eardrum. That’s why you should see a doctor about any ear discomfort. Doctors can’t diagnose a cholesteatoma without removing the growth and examining it under a microscope. 

Without treatment, the cholesteatoma could eat away at the bones that control your ability to hear, leading to permanent hearing loss. The resulting infection could spread to your inner ear or even the brain. You could end up with issues such as:

  • Meningitis
  • A brain abscess
  • Vertigo
  • Facial paralysis

Treatment for a retracted eardrum depends on how serious it is and if there are any complications. 

Will a retracted eardrum fix itself?

Some people with retracted eardrums don’t need treatment. Your doctor may want to keep an eye on your ear and your symptoms until the pressure goes back to normal. This could take a few months.

What medication is used for a retracted eardrum?

If you have a perforated or ruptured eardrum or signs of an infection, your doctor may prescribe antibiotic drops. Steroids are another type of medication your doctor can prescribe for swelling.

Can surgery correct a retracted eardrum?

Not everyone with a retracted eardrum needs surgery. But there are cases in which your doctor might recommend it:

Tympanoplasty. If you have a perforated or ruptured eardrum and the hole doesn’t heal, the doctor may recommend surgery to seal it. During a tympanoplasty, a surgeon will close the hole with a patch. Then, your ear heals over weeks or months.

Tympanostomy (ear tubes). During this procedure, your doctor will drain any fluid in your middle ear. Then, they’ll place tiny tubes in your eardrum to equalize the pressure in your ear. This isn’t a cure for whatever caused the retracted eardrum, but it helps balance the pressure and ease symptoms. The tubes should be checked at least every six months by an ENT specialist. They may become clogged with wax, get infected, or need to be removed.

Eustachian tube dilation. This more recent procedure might be another option. “It’s another minimally invasive way to unclog the eustachian tube for relief of symptoms,” Raphael says. Your doctor will put a balloon through your nasal passages to the opening of your eustachian tube. They’ll fill the balloon with air for a few minutes to open the blocked tube, then remove it.

If you have a cholesteatoma, you’ll likely need surgery to remove it. Your doctor may give you a course of antibiotics to deal with any infection that’s causing drainage. They may want to do a CT scan to get a better look. Depending on how serious your cholesteatoma is, the surgeon may need to rebuild your eardrum or your hearing bones or remove the bone behind your ear.

You may need a second surgery 6-12 months later. You could lose some hearing after the first surgery if there’s a delay in rebuilding your hearing bones. The goal of cholesteatoma surgery is to leave you with a dry ear, free of infection.

How to fix a retracted eardrum at home 

“In minor cases, as in typical discomfort and popping after flying, chewing, swallowing, and light nose blowing may help,” Raphael says. Over-the-counter (OTC) remedies, such as nasal sprays, might help ease congestion. If you do use these products, be sure to use them as instructed.

The Valsalva maneuver could help ease a retracted eardrum for some people. But it needs to be done carefully, and the relief may be very temporary.

To do this maneuver, sit or lie on your back and take a deep breath. Then, try to push the air out and strain (as if you’re pooping) while holding your mouth and nose closed. Hold this for 15-20 seconds as the pressure builds up. Then relax, open your nose and mouth, and breathe normally.

“Blowing too forcefully may result in rupturing the eardrum or spreading infected fluids to the middle ear space,” Raphael says.

But the Valsalva maneuver isn’t safe for everyone. Always check with your doctor before doing it. People who shouldn’t do the Valsalva maneuver include those who have:

  • Retinopathy (a condition that affects the blood vessels in your eye’s retina)
  • Intraocular lens implants in the eye, like after cataract surgery
  • Heart valve disease
  • Coronary artery disease
  • Congenital heart disease

A retracted eardrum is most often caused by a problem in your eustachian tube. Extra pressure pulls your eardrum in, toward your middle ear. Sometimes a retracted eardrum fixes itself, but you might need medication or other treatment to help it along. Check with your doctor if you have:

  • Ear pain for more than a week
  • A feeling of fullness in your ear
  • Fluid draining from your ear
  • Muffled hearing

Here are some commonly asked questions about a retracted eardrum.

Can a sinus infection cause a retracted eardrum?

The most common cause of a retracted eardrum is eustachian tube dysfunction, in which the eustachian tube doesn’t work as it should. If you get a sinus infection, it can cause eustachian tube dysfunction, which in turn can lead to a retracted eardrum.

Can you hear with a retracted eardrum?

It depends. Some people with a retracted eardrum don’t notice any difference in their hearing. Others feel that their hearing is muffled and not as clear. If the eardrum is pressing down on the tiny bones in your ear, you may have hearing loss. If you have cholesteatoma or your ear bones get damaged, you could have permanent hearing loss.

Can you fly with a retracted eardrum?

Yes, you can fly with a retracted eardrum. But there’s a higher chance that you could cause damage to your middle and inner ear. Talk to your doctor before flying to see what you can do to lower the risk of ear damage.

Can you swim with a retracted eardrum​?

As with flying, swimming with a retracted eardrum has risks. Keep water out of your ears because it can lead to dizziness, pain, and infection. Talk to your doctor before you swim if you have a retracted eardrum.