A 19-year-old girl presented with bleeding from the right ear, impairment of hearing and tinnitus following a slap on the right ear one hour before. Physical examination revealed blood clots in the right external auditory meatus. The drum membrane showed a bluish coloration along the handle of the malleus and a central anteroinferior perforation with irregular contused edges. Tuning fork testing revealed Rinne test negative in the right ear and Weber lateralized to the right ear.

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