The regulations are a tad nebulous. I will post them for you, but basically, a perforated ear drum by itself is NOT disqualifying for any class. It becomes disqualifying if it is associated with pathology. SO, if an airman walks into my office with an ice pick in his ear, or a rip roaring middle ear infection that has just ruptured the drum and there is nasty stuff oozing out, that is definitely disqualifying. BUT, if the same person walks in, has a small hole from either of the above from 5 years earlier, and has no hearing disability or positional vertigo, only a hole, than yes, I can certify, at any class level.
Here are the rules (First Class, II
/III are less rigorous, but the pathology part is the same) :
§ 67.105 Ear, nose, throat, and equilibrium.
Ear, nose, throat, and equilibrium standards for a first-class airman medical certificate are:
(a) The person shall demonstrate acceptable hearing by at least one of the following tests:
(1) Demonstrate an ability to hear an average conversational voice in a quiet room, using both ears, at a distance of 6 feet from the examiner, with the back turned to the examiner.
(2) Demonstrate an acceptable understanding of speech as determined by audiometric speech discrimination testing to a score of at least 70 percent obtained in one ear or in a sound field environment.
(3) Provide acceptable results of pure tone audiometric testing of unaided hearing acuity according to the following table of worst acceptable thresholds, using the calibration standards of the American National Standards Institute, 1969 (11 West 42d Street, New York, NY 10036):
Frequency (Hz) 500 Hz 1000 Hz 2000 Hz 3000 Hz
Better ear (Db) 35 30 30 40
Poorer ear (Db) 35 50 50 60
(b) No disease or condition of the middle or internal ear, nose, oral cavity, pharynx, or larynx that—
(1) Interferes with, or is aggravated by, flying or may reasonably be expected to do so; or
(2) Interferes with, or may reasonably be expected to interfere with, clear and effective speech communication.
(c) No disease or condition manifested by, or that may reasonably be expected to be manifested by, vertigo or a disturbance of equilibrium.
"Trust, but verify!" An old Russian proverb, quoted often by a modern American hero