A perforated eardrum is a hole or rupture in the eardrum. It is most often caused by a middle ear infection or trauma. A perforated eardrum is often accompanied by decreased hearing and discharge or bleeding. The amount of hearing loss experienced depends on the degree and location of the perforation. Sometimes a perforated eardrum will heal spontaneously, other times surgery may be needed to repair the hole, with a procedure such as tympanoplasty, myringoplasty, or paper patch. Serious problems can occur if water or bacteria enter the middle ear through the hole, so immediate precautions should be taken prior to your office evaluation with Dr. Bryan or Dr. Mettman.