Otoscopic image (panel A) and schematic diagram (panel B) of a left tympanic membrane. A line drawn along the manubrium of the malleus divides the tympanic membrane into anterior and posterior one-halves (dashed line). A line drawn through the umbo (perpendicular to the first line) divides the tympanic membrane into superior and inferior one-halves (solid line).
Tympanic membrane findings
1. Bulging tympanic membrane
Examples of the white, bulging tympanic membrane seen in acute otitis media.(A) A bulging tympanic membrane with minimal erythema.(B) Tympanic membrane bulging, marked erythema along the handle of the malleus, and an air-fluid level in the anterosuperior portion of the tympanic membrane.
2. Acute perforation with purulent otorrhea
3. Decreased or absent mobility
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۴. Cloudy or opaque tympanic membrane
An air-fluid level is appreciated when the tympanic membrane appears translucent above and opaque below a line demarcating the separation
5. Color of the tympanic membrane 🔷️ A white or pale yellow tympanic membrane usually indicates pus in the middle ear cavity, a sign of AOM
Examples of the white, bulging tympanic membrane seen in acute otitis media.(A) A bulging tympanic membrane with minimal erythema.(B) Tympanic membrane bulging, marked erythema along the handle of the malleus, and an air-fluid level in the anterosuperior portion of the tympanic membrane
