A perforated eardrum can lead to abnormal sound conduction paths and some degree of hearing loss can occur. The extent of the effect on hearing is related to factors such as the size of the eardrum perforation and the cause of the condition. Sound is collected through the eardrum, which vibrates and enters the middle and inner ear, thus accomplishing sound conduction. When a perforated eardrum occurs, the amplitude of the eardrum’s vibrations is reduced, resulting in conductive deafness, which can be characterized by hearing loss. In the case of traumatic eardrum perforation, the impact on hearing is usually low if the perforation area is relatively small, and higher if the perforation area is large. In the case of chronic otitis media, large perforation of the eardrum or destruction of the auditory ossicles, longer lesions can damage the auditory ossicular chain, which will have a more pronounced effect on hearing. Tympanic membrane repair or hearing reconstruction surgery is needed to restore hearing. Perforated eardrums should be examined in a timely manner and a doctor should be asked to diagnose and treat the condition to avoid delays.