The most common cause of a perforated tympanic membrane is infection. Other causes include barotrauma or direct trauma.

A perforated tympanic membrane may lead to hearing loss depending on the size and also increase the risk of otitis media.

Management

• no treatment is needed in the majority of cases as the tympanic membrane will usually heal after 6-8 weeks. It is advisable to avoid getting water in the ear during this time
• it is common practice to prescribe antibiotics to perforations which occur following an episode of acute otitis media. NICE support this approach in the 2008 Respiratory tract infection guidelines
• myringoplasty may be performed if the tympanic membrane does not heal by itself