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Ruptured or perforated eardrums are usually caused by middle-ear infections or trauma (for example, an object in the ear, a slap on the ear, explosions, or repeated, excessive ear pressure from flying or diving).
If healing does not occur with antibiotics or other non-operative treatment, surgery may be necessary.
Chronic middle ear infections are described as:
Signs of chronic ear infections include persistent ear pain, ear drainage, or hearing loss (over a 3-month period).

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