Ear Drum Exam

Apr 2014

Abbreviated Briefing:
  • Check for Perforated Ear Drum
  • Ruptured Ear Drums are not permanently disqualifying if healed


Guidance is compiled and interpreted by professional pilots and physicians at FlightPhysical.com from the 2014 AME Guide pages 46-53, FAA and FDA web data (www.FAA.gov & www.FDA.gov), instructions specified in the Aeronautical Information Manual, Federal Air Surgeon Bulletins from 1999-2015, and 14 CFR Part 61 and Part 67 (the FARs).

The tympanic membranes should be examined for scars or perforations. Discharge or granulation tissue may be the only observable indication of perforation. Middle ear disease may be revealed by retraction, fluid levels, or discoloration. The normal tympanic membrane is movable and pearly gray in color. Mobility should be demonstrated by watching the drum through the otoscope during a valsalva maneuver.

Pathology (diseases or disorders) of the middle ear may be demonstrated by changes in the appearance and mobility of the tympanic membrane. The applicant may only complain of stuffiness of the ears and/or loss of hearing. An upper respiratory infection greatly increases the risk of aerotitis media with pain, deafness, tinnitus, and vertigo due to lessened aeration of the middle ear from eustachian tube dysfunction. When the applicant is taking medication for an ENT condition, it is important that the Examiner become fully aware of the underlying pathology, present status, and the length of time the medication has been used. If the condition is not a threat to aviation safety, the treatment consists solely of antibiotics, and the antibiotics have been taken over a sufficient period to rule out the likelihood of adverse side effects, the Examiner may make the certification decision.

The same approach should be taken when considering the significance of prior surgery such as myringotomy, mastoidectomy, or tympanoplasty. Simple perforation without associated symptoms or pathology is not disqualifying. When in doubt, the Examiner should not hesitate to defer issuance and refer the matter to the AMCD. The services of consultant ENT specialists are available to the FAA to help in determining the safety implications of complicated conditions.

FAA Aerospace Medical Disposition Grid for
Item 30. Ear Drums






Perforation that has associated pathology


Establish etiology, treatment, and submit all pertinent medical information

Requires FAA Decision

Perforation which has resolved without any other clinical symptoms


Submit all pertinent medical information

If no physiologic effects - AME Authorized to Issue the Certificate

Source: Adapted From 2014 AME Guide Pages 48 and 51-53


This page discussed the Ear Drums portion of the ENT section of the Fight Physical Examination required of pilots.

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