OtoRhinoLaryngology Portal

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Early Stage of Infective Inflammation

Figure shows an increased vascularity and early inflammation of middle ear mucosa in reactivated otitis media (+).  Mucous level is seen anteroinferiorly (arrow). M- malleus handle.  Tympanic membrane still appears normal.

Chronic Suppurative Otitis Media (CSOM): Active Stage

Mucopus discharge in the presence of non-closure eardrum perforation

with intermittently or chronically-diseased middle ear mucosal linings.

Reactivation of otitis media following upper respiratory tract infection.

[(+) - mucopus]


Large central perforation with yellowish discharge. 

Greenish discharge in Pseudomonas sp. infection.

 Air bubbles within mucopurulent discharge to suggest presence of eardrum perforation.

 Mucopus flooding the Eustachian tube opening in the middle ear.  (P - posterior, A - anterior) 


Bare handle of malleus with active middle ear infection at the background.

 Whitish fibrinous exudates overlying granulation tissue involving the handle

of malleus and corresponding medial wall of the tympanic cavity.


Granulations involving handle of the malleus with unhealthy perforation edges.

Hyperplastic middle ear mucosa with on-going infection.

Large posterior pars tensa perforation with mucopus seen along the external auditory meatus (+).  (A - anterior, P - posterior)


An active infection with double perforation of eardrum seen.



 Large perforation with blood-stained edges in a recently treated chronic otitis media with active infection.