Which one of the following is characteristic of tubercu otitis media;

Ans. (b) Multiple perforation of pars tensaRef: Dhingra's ENT 5ht ed. / 83Clinical features of Tubercular otitis media:# Painless foul smelling ear discharge: very characteristic finding.# Perforation: multiple perforations usually 2-3 on pars tensa is classical sign of disease.# Hearing loss: There is a severe hearing loss , out of proportion to symptoms . Mostly conductive, it may be SNHL if labyrinth is involved.# Facial paralysis* In the presence of secondary pyogenic infection, tubercular otitis media may be indistinguishable from chronic suppurative otitis media. Culture of ear discharge for tubercle bacilli, histopathological examination of granulations and other evidence of tuberculosis in the body help to confirm the diagnosis.Treatment# Systemic antitubercular therapy as being carried for primary focus.# Local treatment in the form of aural toilet and control of secondary pyogenic infection. Mastoid surgery is indicated for complications. Healing is delayed in tuberculous cases. Wound break-down and fistula formation are common.