A perforated tympanic membrane (ear drum) can occur from diving as well as from non-diving causes. Most traumatic perforations heal spontaneously. Following an appropriate time after they have healed, you can return to diving if your physician feels the healing is solid and there is no evidence of Eustachian tube problems. This usually takes about two months after it is healed.
If the perforation does not heal, then an ear surgeon can repair the damage. After healing has taken place, the same rules about returning to diving above apply. It is important to check for chronic nose and sinus problems if there is no healing.
Chronic perforations that do not heal are a contraindication to diving. Some have advocated the use of ear plugs for these individuals, but if there is any water leakage, it could cause a severe infection.