Perforation of the Tympanic Membrane

A 27-year-old otolaryngology (ENT) resident stopped by the WiscMed booth at the 2021 ENT OTO Experience conference in Los Angeles. He knew that he had an “interesting finding” in his right ear and invited WiscMed staff to examine him. This image was obtained. What is your diagnosis? The ENT resident has a perforation of his tympanic membrane. The resident obtained the perforation to his tympanic membrane from a wipe-out during wakeboarding. The perforation never healed. Interestingly, he indicated that he had no decrease in hearing from the right ear. The defect to the tympanic membrane is located roughly in the same location where a ventilation tube would be placed in the case of chronic middle ear infections (acute otitis media), the anterior-inferior quadrant of the eardrum. A concern regarding a persistent perforation to the TM would be an infection from swimming. The resident did not indicate any problem with infections. In some scenarios, myrinogplasty may be recommended to repair the perforation. This is an example of a larger perforation to the tympanic membrane. Here is a video of the complete exam: