Ear, nose & throat · UKMLA & AKT
Perforated eardrum
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise perforated eardrum — the full SA Note notes add investigations, management, complications and 11 practice questions.
Key high-yield points
- Otalgia - sudden onset; paradoxically improves once AOM-related perforation occurs (pressure decompresses)
- Otorrhoea - serous/haemorrhagic in trauma; mucopurulent in AOM or CSOM
- Conductive hearing loss - impaired TM pressure-to-vibration transduction
- Tinnitus - usually temporary
- Vertigo/dizziness - large perforation or blast injury causing perilymph fistula
- Otoscopy - visible tear/hole in TM; note site (central vs marginal/attic), size, and discharge
Pars flaccida (attic) or marginal perforation requires urgent ENT referral - squamous epithelium can migrate inward, seeding a cholesteatoma.
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