Rupture or perforation (hole) of the eardrum can occur in infection, trauma (e.g. by trying to clean the ear with sharp instruments), explosion or loud noise. Flying with a severe cold can also cause perforation due to changes in air pressure and blocked eustachian tubes resulting from the cold. This is especially true on landing.

Perforation of the eardrum leads to conductive hearing loss.

The perforation may heal in a few weeks, or up to a few months. Some perforations require intervention – this may use a paper patch to promote healing (simple procedure in the office of an ear, nose and throat specialist), or surgery (tympanoplasty).

Hearing is usually recovered fully, but chronic infection over a long period may lead to permanent hearing loss.

Surgical repair of the eardrum tympanoplasty may be needed if the eardrum does not heal on its own.