Traumatic tympanic membrane perforation can be caused by direct or indirect external forces, including instrument injuries such as piercing the eardrum by digging with matchsticks, wool needles, cotton swabs, etc., or poking or burning with slag sparks, and pneumatic injuries such as forceful nose blowing or breath-holding, palm striking the ear, blasting, shell shock, firecrackers, high diving, kissing the ear, etc. Fractures of the temporal bone involving the tympanic membrane and foreign bodies in the external ear canal can also cause perforation of the tympanic membrane. What are the manifestations after tympanic membrane perforation? 1. When the tympanic membrane ruptures, there will be sudden ear pain of varying degrees, ear bleeding, hearing loss, tinnitus, and a sense of ear occlusion. Patients feel gas spilling out of the ear when they blow their nose. It may be accompanied by vertigo, nausea, or mixed deafness. 2. Endoscopic examination of the ear reveals an irregular perforation of the tympanic membrane with a small amount of blood at the edge of the perforation, and blood or blood crusts are sometimes visible in the external ear canal. Direct trauma usually causes posterior and inferior perforation of the tympanic membrane, while indirect trauma causes more perforations located in the anterior and inferior parts of the tympanic membrane. If there is clear water-like fluid outflow, it indicates cerebrospinal fluid ear leakage. 3. Audiological examination shows that the deafness is conductive, or mixed if accompanied by vagus injury, with varying degrees of severity. If traumatic tympanic membrane perforation is clearly identified, how should it be treated? The treatment for traumatic tympanic membrane perforation is usually conservative observation for 1-3 months, and surgical repair of the tympanic membrane is required if it fails to heal after observation. During the conservative observation period, patients are generally advised not to get water in the ear and to prevent colds. External ear canal irrigation or in-ear drops are not allowed, and patients are advised not to blow their noses too hard. Small perforations usually heal on their own within 3-4 weeks. Different doctors handle the conservative observation period differently, and generally do not advocate the application of antibiotics, but for those with secondary infections, they need to be used.