Symptoms usually occur only during the change in pressure, and perhaps for a short time afterward. More severe cases, including serous otitis media, can last longer, perhaps weeks or months. Perforations of the eardrum often heal on their own, but this can take weeks. You may not be able to hear as well until the ear is fully healed. If your perforation has not healed after two months, you may need surgery to prevent permanent hearing loss.