Patients with air leaks in the ear are often the result of a perforated eardrum, which may be caused by acute suppurative otitis media or chronic suppurative otitis media in the past. Some patients may also suffer from trauma to the ear or damage to the eardrum from digging too deeply into the ear. The perforation of the eardrum may be caused by excessive force during nasal pinching and puffing, which may lead to a feeling of air leakage from the ear.