Tympanic membrane perforations that persists for more than 3 months or more are known as chronic perforation. They do not heal by medical treatment, spontaneously or by any pathy. They should be closed by micro-surgical procedure called tympanoplasty. The procedure involves minimal scar , with over-night stay at hospital with minimal morbidity. Some small perforations of recent origin may close spontaneously, but the healed membrane lacks the fibrous layer necessary for it's strength. It melts away with the next upper respiratory track infection.