Tympanic Membrane Defect with Middle Ear Discharge

A 15-year-old male presents to the pediatric clinic with ear discharge. The patient has had a history of two tympanoplasties by ENT. He does not have any ear pain. He does have decreased hearing. What is your diagnosis? This patient has Tympanic membrane defect with Middle ear discharge. The patient has a chronic appearing tympanic membrane defect. In addition, when the patient does the Valsalva maneuver, fluid draining from the middle ear space is clearly seen. It is not clear the nature of the fluid, but an infection was suspected. The patient was placed on antibiotic drops and referred to ENT. WiscMed thanks Dr. Jack Whitehead of Brentwood Children's Clinic of Brentwood, Tennessee for this interesting case.