Barotrauma: This is the most likely diagnosis, especially if the patient has recently undergone air travel, diving, or other activities that involve significant changes in atmospheric pressure. The pressure change can cause the eardrum to rupture, leading to bleeding.

Infection (e.g., otitis media or externa): Infections of the ear can cause bleeding, especially if there is a perforation of the eardrum or if the infection is severe.
Trauma: Direct trauma to the ears, such as a blow to the head or ears, can cause bleeding.
Foreign body: The presence of a foreign body in the ear can cause irritation, infection, or direct trauma, leading to bleeding.

Basilar skull fracture: Although less common, a basilar skull fracture can cause bilateral ear bleeding due to the fracture line extending into the temporal bone. This is a potentially life-threatening condition that requires immediate medical attention.
Meningitis: In rare cases, meningitis can cause bleeding in the ears, especially if there is a rupture of the dura mater or other complications.

Hemorrhagic disorders (e.g., hemophilia): Certain bleeding disorders can increase the risk of ear bleeding, although this would be a rare cause of bilateral ear bleeding.
Vascular malformations or tumors: Abnormal blood vessels or tumors in the ear can cause bleeding, although these conditions are rare and would typically be associated with other symptoms.
Systemic diseases (e.g., Wegener's granulomatosis): Certain systemic diseases can cause ear bleeding, although these conditions are rare and would typically be associated with other systemic symptoms.