3) Eardrum (Tympanic Membrane) Perforation

is surely an alarming sign with multiple consequences, particularly in the case of a middle ear infection. The eardrum is a strong membrane with some flexibility, so it isn’t easily perforated. However, a severe external ear infection may cause necrotizing (damage) of the eardrum. Foreign bodies impacted in the external ear may cause injury to the eardrum, yet eardrum perforation is more common during the trial of an inexperienced individual to extract the impacted foreign body.
The middle ear should be separated from the external ear by the eardrum, so perforation of the eardrum and exposing the middle ear significantly increase the risk of developing otitis media.