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 presentation
- 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