| A | B |
|---|
| Appearance of cerumen in Native Americans and in persons of Asian descent | dry and flaky cerumen that is sometimes mistaken for eczema |
| Appearance of cerumen in individuals of African and European descent | moist, sticky, honey to dark brown color |
| Normal TM appearance in newborn to 1st month or so | reddened, thick, and opaque |
| Normal TM appearance in elderly | whiter, more opaque, more dull |
| Otitis Externa (aka "swimmer's ear) | Redness and swelling of external auditory canal (canal may be closed). Purulent or watery exudate may be present |
| Otitis Media with Ruptured TM | May not be able to visualize TM due to large amount of purulent exudates which fills external auditory canal |
| Ruptured TM | In absence of Otitis Media, appears as a hole in the TM |
| Scarred TM | Opaque white area on TM that may occur following severe or repeated infections |
| Basal Skull Fracture | Drainage (usually bloody) from ears following trauma. The drainage will be + for glucose |
| Serous Otitis Media | TM may be yellowish. Air bubbles and fluid visible behind drum |
| Otitis Media | TM injected (i.e. redness due to dilation of blood vessels secondary to an inflammatory or infectious process) |
| Normal TM | Shiny, translucent, pearl-gray color |
| Bulging TM | Occurs due to build up of pus in middle ear that may occur with Otitis Media |
| Retracted TM | Bony landmarks appear prominent. Malleus appears shorter and more horizontal. Light reflex distorted |
| Tympanostomy Tubes | Appear as white or colorful tubes or “buttons” in TM |
| TM hypomobility | Decreased response to insufflation that occurs in the presence of Otitis Media, retracted TM, or Serous Otitis |
| Roaches and Peas | Foreign bodies that may be discovered. |
| Hemotypanum | Blue TM due to blood behind TM - assess for trauma and skull fracture (side note: Blood behind TM may also appear dark red) |
| Osteoma | single bony non-tender rounded nodule covered by normal skin - obstructs view of TM |
| Exostosis | small bony projections of hypertrophic bone covered by normal skin.- usually do not obstruct view of TM |
| Bullous Myringitis | vesicles on TM (FYI: myringa is latin for eardrum) |
| Impacted Cerumen | Large amount of cerumen that blocks visualization of TM. Over time it may become as a hardened plug. Common cause of conductive hearing loss. |
| Tophi | White to yellow hardened uric acid crystal accumulations in or near the helix. Indicate hyperuricemia and may be a sign of gout |
| Otomycosis | Fungal infection of the ear – may appears as groups of black or white dots on TM or along ear canal wall |
| Cholesteatoma | cystic overgrowth of epidermal cells and cholesterol. Enzymes produced by it may erode bone. It can also occlude the middle ear and lead to hearing loss. |
