How to tell if my ear perforation from diving needs surgery or can heal with medicine?

Based on your symptoms and being exposed to dirty water, it’s quite possible that the ear infection is complicating your eardrum perforation. Typically, small perforations due to barotrauma from diving can heal by themselves over several weeks, especially when the underlying infection is managed. However, the presence of yellow discharge with a fishy smell suggests an infection that needs immediate attention. The antibiotic (ZIS-BIOTIC) you’ve been prescribed is likely to tackle this infection. It’s crucial to complete this antibiotic course as infections can hinder the healing process of the perforated eardrum. Surgery isn’t always the first step especially for small perforations; it’s generally considered when the perforation doesn’t heal after an observation period, or if there’s chronic infection impacting hearing. Observing the healing process over the course of four to six weeks while adhering to prescribed medication and keeping the ear dry usually gives significant insights. If the perforation doesn’t show signs of improvement, then an ENT specialist might recommend surgical intervention like tympanoplasty. It’s strongly advised to avoid introducing anything into the ear, even water, which can worsen the condition. Keep a close eye on any changes; increased pain, bleeding, or new symptoms like dizziness would warrant a prompt reevaluation by a healthcare professional. Follow up with your doctor regularly during this period to monitor healing and ensure there’s no worsening or complications developing.