A perforated eardrum is a hole in the eardrum. We call it a tympanic membrane perforation and there are many different causes. The most common cause is an ear infection that ruptures the eardrum. And such perforations always heal spontaneously. However, if you have repeated ear infections and repeated ruptures the hole might not close. The second most common cause of a hole in the eardrum is trauma. And this can be direct trauma, from using a Q-tip or sticking a foreign body in your ear or from being hit over the ear. So sometimes if someone is slapped over the ear pressure will push through the eardrum. Whenever your eardrum ruptures you should immediately seek medical attention. Particularly if you're having any dizziness associated with this. A ruptured eardrum will usually cause some degree of hearing loss. Many ruptured eardrums will heal spontaneously and they should be given some time to heal. After a period of time if there's no evidence of healing a ruptured eardrum can be repaired surgically.