Aetiology

• Mainly seen in the younger population associated with acute otitis media
• Can be caused by trauma e.g. sudden negative pressure, insertion of objects into the ear

Clinical features

• Sudden severe pain sometimes followed by bleeding from the ear, hearing loss, and tinnitus

Investigations

• Otoscopy: perforation visible

• Audiometry: conductive hearing loss

Management

• Usually heals spontaneously
• Surgical repair is only indicated if the patient is symptomatic with recurrent discharge