What does a finding of tympanic membrane perforation indicate in acute otitis media (AOM)?

Updated: Sep 25, 2019
  • Author: John D Donaldson, MD, FRCSC, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Perforation of the tympanic membrane is not unusual as the process advances, most frequently in posterior or inferior quadrants. Before or instead of a single perforation, an opaque serumlike exudate is sometimes seen oozing through the entire tympanic membrane.

With perforation and in the absence of a coexistent viral infection, the patient generally experiences rapid relief of pain and fever. The discharge initially is purulent, though it may be thin and watery or bloody; pulsation of the otorrhea is common. Otorrhea from acute perforation normally lasts 1-2 days before spontaneous healing occurs. Otorrhea may persist if the perforation is accompanied by mucosal swelling or polypoid changes, which can act as a ball valve.

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