A 25-year-old man presents with recurrent left ear discharge since childhood. The discharge is profuse, mucoid and odourless. Otoscopy shows a large central perforation of the pars tensa. This pattern of discharge is characteristic of:
- A Atticoantral disease with early cholesteatoma
- B Tubotympanic disease with active mucosal inflammation ✓
- C Tuberculosis of the middle ear cleft
- D Healed quiescent CSOM with secondary fungal otitis externa
Correct answer: B. Tubotympanic disease with active mucosal inflammation
Explanation
In tubotympanic (safe) CSOM, discharge is typically profuse, mucoid or mucopurulent and odourless because it arises from inflamed middle ear mucosa without bone erosion. Foul-smelling scanty discharge suggests atticoantral disease with cholesteatoma, where keratin debris undergoes putrefaction by saprophytic organisms. Odour is therefore the bedside discriminator between safe and unsafe ears.
Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.