A tympanic membrane perforation is a hole in the eardrum. It may occur as a result of trauma to the eardrum, an acute infection, chronic infection, or a cholesteatoma. Some perforations will heal on their own without treatment (usually those that have resulted from trauma or acute infection), while others may require surgery (myringoplasty or tympanoplasty). Some cases may require mastoidectomy as well, in order to remove a source of chronic infection. The ear should be kept dry while a perforation is present in order to provide the best environment for healing as well as to prevent infection and other complications.