Which combination of discharge characteristics best distinguishes the UNSAFE (atticoantral) ear from the SAFE (tubotympanic) ear?
- A Profuse, mucoid, non-offensive versus scanty, purulent, foul-smelling respectively
- B Both produce scanty, watery, odourless discharge
- C Scanty, purulent, foul-smelling versus profuse, mucoid, non-offensive respectively ✓
- D Both produce profuse, purulent, foul-smelling discharge
Correct answer: C. Scanty, purulent, foul-smelling versus profuse, mucoid, non-offensive respectively
Explanation
The unsafe ear with cholesteatoma produces scanty but persistently purulent discharge that is characteristically foul-smelling because of keratin debris undergoing putrefaction and osteitic bone. The safe tubotympanic ear discharges profuse, mucoid or mucopurulent secretion that is non-offensive, arising from inflamed mucosa. Odour is therefore the bedside clue: offensive discharge mandates exclusion of cholesteatoma even when the perforation appears small.
Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.
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Written and medically reviewed by the StethoPrep medical team.