A discharging ear is the most common presenting symptom for ENT conditions. However, some degree of hearing loss is always present. In order to compare the degree of hearing impairment with the size and location of the perforation, we made an effort to conduct this study. The purpose of the study is to ascertain whether, and if so, what, a relationship exists between the location and extent of the tympanic membrane perforation and the severity of hearing loss. In a systematic scoping review of randomized controlled trials, each database was subjected to a unique systematic search approach. Utilizing the methodological approaches specified in the Cochrane Handbook for Systematic Reviewers, a systematic scoping review is conducted after selection criteria, with results reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Tympanic membrane anomalies are the root cause of various degrees of conducive deafness. The size of the perforation affects how much hearing is lost. More of an impact is felt on lower frequencies than on higher frequencies. More deafness results from posterior-inferior perforations than anterior-inferior perforations.