Hearing loss occurs with ruptured eardrums, particularly due to scarring of the tympanic membrane. I can attest to that, personally. While the membrane can be recovered, hearing loss is very real, particularly in various frequency bands (remember that hearing loss is a sliding scale that's not just volume, but frequency). After a lifetime of radial engines, gunfire, ruptured eardrums, and so on, and the scarring of the membrane to show for it, I can still pass a medical, but there's no question that hearing loss occurred.

I asked an enlisted soldier in Iraq if he had a headcold or any ear issues, on night, as I intended to do a steep descent. He said he had just one ear drum left, due to a rocket-propelled grenade in Baghdad. "It's okay, sir," he said, "if the army wants me to have another eardrum, they'll give me one." I appreciated his gung-ho enthusiasm, however misplaced, but made a slower descent in the interest of his remaining ear. We lose our hearing one way or another, and the reality is that most of the time, we don't get it back. We often lose it in degrees; it's the most common disability in the US military, for good reason, and in aviation we're exposed to a lot of noise and hazards. The potential for a ruptured eardrum is among them. I've experienced incidents involving a blockage I didn't know I had, one explosive depressurization (windscreen blew out), one rapid depressurization (door seal failed), altitude chamber events, an event during a skydive, and was deaf for a month after a rapid descent and depressurization in a Fokker. Rupture an eardrum, and there's a good chance you'll have scarring on your tympanic membrane, and that will affect your hearing whether you appreciate it or not. Certainly it will cause loss in one or more frequency ranges; most of us have that to some degree and are blissfully unaware. Someo of us have it in many of those ranges.

Some years ago I found a reference to online hearing tests. I visited a site which featured a number of buttons, each representing a frequency range, and tapped on them. Nothing. I didn't expect a lot, given that it was over a laptop internal speaker, but shortly one of my kids ran into the room and asked what I was doing. He said "cut it out, it hurts." He couldn't see my screen, so I tapped the button again, and he responded. I tried a different button, and the dog yelped. Out of all the buttons on the screen, the kids could hear 100%. I heard two, I believe. It's far from just ruptured eardrums; I spent a lot of time with radial engines with short-stacks that are like 56 12-gauge shotguns firing continuously, and years firing thousands of rounds of ammunition a month; none of those are hearing-friendly, either, but busting one's eardrums will have a lasting effect, whether one realizes it or not, and the effect will be cumulative. That scarring remains. It's not simply hearing things less, or that things seem quieter; it can be a subtle loss in a given frequency range. I hear parts of music, but not all of it. I prefer older musci becasue I know it and my mind fills in the blanks, whereas newer music, I don't know what I'm not hearing; the loss is there. The tinitus is there, all the time. I can still pass the medical, but it doesn't alter the fact, and it's been noticeable after trauma to the ear. You might be lucky and come away with no loss, after a tympanic tear or rupture, but you'd be the rare one. When a doctor states that there's no loss, it's an aggregate statement; the person may still hear, but that's a wide open statement with a very wide spectrum; there's hearing, and then there's hearing. One needs to hear a spoken voice for a medical. That doesn't mean there's a lot that's still missing, and whether one realizes it or not in their daily life, after a tympanic rupture, there will be loss.

Damage to internal structure in the ear, or nerve damage, will typically not be recoverable.