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A hole in the ear drum of long standing duration will lead to a hearing loss if it is not corrected in time. A microscopic examination of the affected ear along with a x - ray / CT scan of the ear to rule out if there is any bone involvement should be done asap. An ear surgery could be the next step. The surgery will correct the hole in the ear drum & will remove all the diseased bone (which is behind the ear) if there is any bone involvement.
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