Tympanic membrane perforation: The Daily PANCE Blueprint
A 52-year-old male is flying to Asia when suddenly he develops severe right ear pain and dizziness. You happen to be next to him on the plane with your otoscope in your bag. He allows you to examine his ear, which shows a tear in the tympanic membrane. What location is the tear likely at?
A. Pars tensa
B. Pars flaccida
C. Annulus
D. Posterior malleolar
E. Umbo
Answer and topic summary
The answer is A. Pars tensa
A perforated tympanic membrane is defined by some sort of breach/tear between the ear canal and middle ear. Etiologies include mechanical trauma, barotrauma (e.g., scuba diving or air travel), or infection. Clinical features include sudden, acute otalgia, otorrhea, tinnitus and vertigo. The most common location for a perforated TM is the pars tensa, as it is the largest and thinnest area of the TM. Most perforations resolve on their own without complications and treatment is generally supportive. Routine antibiotics are not necessary. Complications such as mastoiditis, cholesteatoma, otitis media, and hearing could technically occur (albeit rare).
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint EENT ⇒ ⇒
Also covered as part of the Family Medicine EOR, Emergency Medicine EOR, and Pediatric EOR topic lists
