Sudden-onset of hearing loss after a slap.

1. Left ear otoscopy revealed a perforated tympanic membrane postero-inferiorly with ragged edges. There was minimal blood clot noted with no active bleeding (Figure 1). Examination of left eye showed chemosis and conjunctival hemorrhage (Figure 2). Tympanic membrane perforations resulting from direct trauma tend to have ragged edges, while a hard slap usually results in a triangular or linear tear of the tympanic membrane.1 The most common site of perforation is posterior.2