NHS direct

A perforated eardrum is one with a hole in it. Most perforations occur following infection (otitis media) and heal quickly.

Non-infective perforations often heal quickly without further attention. However, if the middle ear becomes infected, and especially if there is loss of normal middle-ear drainage by the eustachian tube connecting the middle ear to the throat, the perforation tends to persist and requires treatment.

(That's me, that is).