Which of the following is a features of tympanic membrane perforation –
**Core Concept**
Tympanic membrane perforation involves a breach in the integrity of the eardrum, leading to a disruption in the normal functioning of the middle ear. This condition can result from various causes, including infections, trauma, or iatrogenic factors.
**Why the Correct Answer is Right**
A tympanic membrane perforation typically presents with a history of otorrhea, a sensation of fullness or blockage in the ear, and decreased hearing. The perforation can be central or marginal and may be associated with a retraction pocket or cholesteatoma. The middle ear's negative pressure is usually lost, and the eardrum's movement is impaired. This condition can be diagnosed through otoscopy, tympanometry, or acoustic reflex testing.
**Why Each Wrong Option is Incorrect**
**Option A:** A tympanic membrane perforation is not characterized by a normal tympanogram, as the perforation disrupts the normal vibration of the eardrum.
**Option B:** A tympanic membrane perforation does not typically present with a conductive hearing loss due to ossicular chain discontinuity, which is more characteristic of a middle ear effusion or ossicular damage.
**Option C:** A tympanic membrane perforation may be associated with a conductive hearing loss, but it is not a feature of a sensorineural hearing loss, which is typically due to inner ear or auditory nerve pathology.
**Clinical Pearl / High-Yield Fact**
In cases of suspected tympanic membrane perforation, it's essential to inspect the ear canal and tympanic membrane carefully to identify the extent and location of the perforation, as this information guides further management and treatment.
**Correct Answer: C. Conductive hearing loss.**