I’m sorry to hear about your situation. Given your history of trauma and the persistence of hearing loss and tinnitus (noise inside the ear) despite the healing of your eardrum, several possibilities could be considered:

1. Sensorineural Hearing Loss (SNHL):
– Cochlear Damage: The trauma from the assault could have damaged the hair cells within the cochlea, leading to sensorineural hearing loss. This type of hearing loss is often permanent and can be accompanied by tinnitus.
– Otic Capsule Injury: If the trauma was severe, it might have affected the otic capsule, which can result in profound sensorineural hearing loss. This is usually permanent and not amenable to surgical correction.

2. Ossicular Chain Disruption:
– Although your eardrum has healed, there could be an issue with the ossicles (the small bones in the middle ear) that transmit sound from the eardrum to the inner ear. Disruption or fixation of these bones can lead to conductive hearing loss.

3. Perilymph Fistula:
– Trauma can sometimes cause a perilymph fistula, which is an abnormal connection between the middle ear and the inner ear. This can lead to hearing loss and tinnitus.

4. Chronic Middle Ear Effusion:
– Although less likely given the time elapsed, persistent fluid in the middle ear could contribute to hearing loss.

5. Tinnitus:
– The persistent noise you hear could be due to damage to the auditory pathways or the cochlea itself. Tinnitus often accompanies sensorineural hearing loss.

Recommendations:

1. Audiological Evaluation:
– A comprehensive hearing test (audiometry) is essential to determine the type and degree of hearing loss.

2. Otolaryngology Consultation:
– An evaluation by an ENT specialist is crucial. They may recommend imaging studies, such as a CT scan or MRI, to assess the middle and inner ear structures.

3. Management Options:
– Hearing Aids: If sensorineural hearing loss is confirmed, hearing aids may help improve hearing and manage tinnitus.
– Cochlear Implants: In cases of severe sensorineural hearing loss, cochlear implants might be considered.
– Tinnitus Management: Techniques such as sound therapy, cognitive behavioral therapy, or tinnitus retraining therapy can be beneficial.

4. Protective Measures:
– Protect your ears from further trauma and avoid exposure to loud noises to prevent exacerbation of hearing loss.

It is important to follow up with healthcare professionals for a tailored management plan based on your specific condition.