This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: ENT
A characteristic feature of TB otitis media: 
Select and explain. 
A. Multiple perforations in TM, B. Mastoiditis, C. Middle ear effusion, D. Ear discharge
A: Multiple perforations in TM
Answer: A: Multiple perforations in TM 
Explanation: TB otitis media is mostly secondary to pulmonary TB.
More common in children and young adults. Patients have painless ear discharge which may be foul smelling and severe conductive hearing loss which is out of proportion to symptoms.
On examination, multiple perforations are seen on the tympanic membrane, pale granulation tissue in the middle ear and there may be facial nerve palsy. Investigations include the culture of the discharge. Histopathological examination of the granulation tissues and chest X-ray for ruling out pulmonary TB.
Treatment is with Antitubercular drugs.