This section briefly illustrates some important common pathologies and compares them to what you’ll observe in a normal ear canal, and tympanic membrane. Select the pathology you’re interested in to find out more.

Normal Tympanic Membrane
The normal tympanic membrane is a pale, gray, ovoid, semitransparent membrane located at the end of the external auditory canal.

Acute Otitis Media

Normal
The acute infection of the middle ear cleft frequently intensifies upper respiratory tract infections and occurs most commonly in children.

Chronic Suppurative Otitis Media

Normal
Chronic suppurative otitis media is characterized by recurrent, painless otorrhea, or discharge from the ear.

Cholesteatoma

Normal
A cholesteatoma is a slowly expanding and eroding cyst lined with stratified squamous keratinizing epimetheus with involves the middle ear cleft.

Foreign Body

Normal
A foreign body, or an unsuccessful attempt to remove it, can cause damage to the tympanic membrane.

Otomycosis

Normal
Otoscopic examination reveals a white or cream-colored, thickish debris which may have a fluffy appearance.

Red Reflex

Normal
The introduction of a speculum into the ear canal, or prolonged crying in a child, can cause vasodilation that mimics otitis media.

Keratosis Obturans

Normal
In this condition, the bony meatus is typically obstructed by a stony, hard plug of whitish keratin debris.

Tympanosclerosis Involving the Ossicles

Normal

Adhesive (Atrophic) Otitis Media

Normal
In this case, a thick, atrophic tympanic membrane is draped over the head of the stapes, and the tip of the long process of the incus has been eroded.

Traumatic perforation

Normal
These perforations result from a variety of causes, including a blow to the ear, blast injury, the insertion of a cotton tipped swab or bobby pin, and, rarely, forceful syringing.

Tympanostomy Tube

Normal
A tympanostomy tube is often inserted into the tympanic membrane to ventilate the middle ears in cases of serous otitis media.

Exostosis

Normal
Exostosis appear as discrete, hard, round, or oval outcroppings which are sometimes pedunculated.

Healed Central Perforation

Normal
When a large perforation heals, the middle fibrous layer of the tympanic membrane remains deficient.

Serous Otitis Media

Normal
In serous otitis media, the tympanic membrane is retracted and will show decreased mobility.

Acute Otitis Externa

Normal
In acute otitis externa, the skin of the ear canal is painful, infected, and swollen, and it may be impossible to visualize the tympanic membrane.

Central Perforation of the Tympanic Membrane

Normal
Perforations of the pars tensa of the tympanic membrane can result from infection or trauma. In this case, the large, central perforation resulted from repeated middle ear infections.

Tympanosclerosis

Normal
Tympanosclerotic plaques of varying sizes are seen as chalky white deposits in the tympanic membrane.