Hemotympanum refers to both the presence of blood in the middle ear cavity and ecchymosis of the tympanic membrane (TM). Common causes of intra-tympanic membrane (iTM) hemorrhage include - a temporal bone fracture due to blunt head trauma, therapeutic nasal packing, epistaxis, blood disorders, anticoagulant therapy, barotrauma, and otitis media.

Source: Chang Hee Kim, 2018. Journal of Otolaryngology-Head & Neck Surgery