Attic perforation with a foul-smelling discharge, scanty in quantity, and presence of a whitish flaky material in the attic on otoscopy is MOST characteristic of:

• A Tubotympanic (safe) CSOM
• B Otomycosis
• C External otitis
• D Atticoantral (unsafe) CSOM with cholesteatoma ✓

Explanation

Atticoantral (unsafe) CSOM presents with a marginal or attic perforation, scanty foul-smelling discharge (from putrefaction of accumulated keratin), and visible whitish-grey flaky (keratin) material in the attic — the hallmarks of cholesteatoma. Tubotympanic CSOM has a central perforation with profuse mucoid discharge and no cholesteatoma. Otomycosis shows fungal hyphae/spores. External otitis does not have a perforation at the attic.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.