Ear, nose & throat · UKMLA & AKT
Perforated eardrum
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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