Perforation of the Tympanic Membrane

A 55-year-old male with chronic right ear discharge and hearing loss presents for evaluation at the ENT clinic. He has a history of recurrent acute otitis media treated with multiple courses of antibiotics. He has had ventilation tubes in the past. This image is obtained. The patient has a perforation of the tympanic membrane. You can clearly see the defect in the tympanic membrane (TM, eardrum), it is the circular area on the left-middle of the image. This is anatomically the inferior portion of the TM, located in the pars tensa. The malleus is also clearly visible extending from the center of the image to about the 5 O’clock position. The defect is likely due to the history of ventilation tubes and poor healing of the TM. In addition, the patient has myringosclerosis. This is the white area at the bottom of the image. WiscMed thanks Dr. Todd Morrow of Associates in Otolaryngology, West Orange, NJ for this interesting case.