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How can a perforated tympanic membrane affect hearing?

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Cross-section diagram of the human ear showing the outer ear, middle ear, and inner ear, with labeled parts including the auricle, auditory canal, tympanic membrane, ossicles, cochlea, semicircular canals, and nerves. — human ear Structure of the human ear.

The tympanic membrane is essential for hearing because it receives sound vibrations from the outer air and transmits them to the auditory ossicles in the middle ear. When this membrane is perforated—whether due to trauma, pressure changes, or severe otitis media—its ability to effectively transmit these vibrations is compromised.12

A perforation can lead to varying degrees of hearing loss because the damaged membrane cannot properly conduct sound energy into the middle ear. Additionally, a persistent hole in the eardrum increases susceptibility to middle ear infections and the development of cholesteatoma, both of which can further impact auditory health. While many perforations heal on their own within a few weeks, failure of the membrane to close may require medical intervention, such as a patch or surgery, to restore proper function and prevent long-term complications.12