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Puncturing the tympanic membrane is a significant concern when using cotton swabs in the ear. The tympanic membrane, or eardrum, is a thin membrane that separates the external ear from the middle ear. It plays a crucial role in hearing by vibrating in response to sound waves and transmitting those vibrations to the ossicles in the middle ear.

When a cotton swab is inserted too deeply into the ear canal, it can inadvertently come into contact with the tympanic membrane, leading to a puncture or tear. This can cause pain, hearing loss, and potential infections, as the middle ear may become exposed to external debris and bacteria.

While the external auditory canal is the passage leading to the eardrum and a cotton swab can cause irritation or minor injury there, it is the tympanic membrane that is at risk of puncture from deep insertion. The middle ear and ossicles, on the other hand, are located deeper in the ear and are less likely to be directly affected by the insertion of a cotton swab unless the eardrum has been compromised.