Question

Multiple perforations of tympanic membrane is a feature of

• A. Trauma
• B. Tuberculous otitis media
• C. C.S.O.M.
• D. Aspergillosis

Hint:

Think about the ear infection known for painless discharge and hearing loss out of proportion to the perforation.

Answer 1

The Correct Option is B

Step 1: Understanding the Question:
We need to identify which ear disease classically shows many small perforations in the eardrum rather than one single hole.

Step 2: Key Formula or Approach:
Different causes of tympanic membrane perforation have different classic patterns. Trauma and simple chronic infections usually give a single hole, while some infections attack the drum at several points at once.

Step 3: Detailed Explanation:
Trauma, such as a slap injury or a foreign body, usually punches a single, often irregular, perforation at one spot on the eardrum.
Chronic suppurative otitis media (C.S.O.M.), the common form of chronic ear infection, usually causes one central perforation, or sometimes a marginal one, but not many separate holes.
Aspergillosis is a fungal ear infection (otomycosis) that mainly fills the ear canal with fungal debris, it does not typically create multiple perforations on its own.
Tuberculous otitis media is different. The TB bacteria attack the eardrum at several points at once, so several small perforations appear together. Over time these small holes enlarge and merge into one big ragged perforation. The disease is also known for painless, thin, watery discharge and hearing loss that is much worse than the size of the perforation would suggest, along with pale, unhealthy looking granulation tissue in the middle ear.

Step 4: Final Answer:
So multiple perforations of the tympanic membrane, later joining into one large perforation, is a classic feature of tuberculous otitis media.