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
Classical findings of tubercular otitis media: 
Select and explain. 
A. Pain out of propoion to symptoms, B. Mastoiditis, C. Scanty discharge, D. Multiple perforation
D: Multiple perforation
Answer: D: Multiple perforation 
Explanation: Generally tuberculosis of middle ear is unilateral. Tuberculosis of middle ear is characterized by painless otorrhoea which fails to respond to the usual antimicrobial treatment, in a patient with evidence of tubercle infection elsewhere followed by multiple tympanic membrane perforations, abundant granulation tissue, and bone necrosis, preauricular lymphadenopathy. There may be multiple perforations in the early stages, but they coalesce into a total tympanic membrane perforation accompanied by a pale granulation tissue