Dear All,
Posting a few images of ears for clinical discussion.

Image No. 1) 

Image No. 2)

Points to notice -
1) Both the images are of the RIGHT ear as is our protocol ( for matters of convenience).
2) Image No. 1 shows a big DEFECT in the Tympanic Membrane.
3) Image No. 2 shows multiple discrete chalky flakes on the Tympanic Membrane....these are typical TYMPANOSCLEROTIC patches which suggest old affection of the Middle Ear (probably an old c/o Otitis Media)...this is an extension of our discussion yesterday in the theory class on Otosclerosis.....this condition can mimic Otosclerosis (Differential diagnosis) in the sense that here too patient may complain of hard of hearing WITHOUT any h/o earache, otorrhoea ....the ONLY thing that will distinguish it from Otosclerosis is the ABNORMAL appearance of TM.

Points to ponder -
1) Which type of perforation does the Image No. 1 denote?
2) What is the type of CSOM here?
3) What are the Synonyms for this type of CSOM?
4) Waht is the Management of this condition?

Dear Friends,
Posting some images

Trick photography apart, my intention is to draw your attention to the utmost importance one needs to attribute to the perception of the third dimension....THE DEPTH OF FIELD ....to get an idea of the relative distance of objects from one another...In ENT (as anywhere in life) and more so in an accurate ear examination and to come to correct diagnosis,Sterioscopic or Binocular vision is A MUST. To ensure this, the classical or conventional ENT Setup of Bull's Eye Lamp and Head Mirror is extremely useful...