Why is there irreversible hearing loss in unsafe otitis media?

Why is there irreversible hearing loss in unsafe otitis media?

In this video, Dr. Nishi Gupta, Head department of ENT, Dr. Shroffs Charity Eye Hospital, Delhi, talks about the cause of irreversible hearing loss in unsafe otitis media. The otitis media is called unsafe because there might not be a clear perforation in the ear drum and the discharge might not come out of the middle ear. This can lead to increase pressure on the internal ear bones which gets diseased. In this process of infection, the bones are necrosed leading to hearing loss.