A 17-year-old male presents to the pediatric clinic for a routine sports exam. He has no complaints. He has a history of a tympanic membrane perforation of his right ear. Examination of his right ear with the Wispr digital otoscope reveals this image.

What is your diagnosis?

The patient has myringosclerosis (sclerosis) with evidence of a healed perforation.

The tympanic membrane (ear drum) is made up of three relatively thin layers of tissue. This allows the eardrum to vibrate from sound waves, but it also makes the structure susceptible to perforations. A perforation can occur from high-intensity sound waves like a firecracker, from pressure in diving into the water, or from devices such as q-tips or earbuds. A perforation can also be caused “on purpose” by a medical procedure to install ear tubes.



When the perforation heals, there is often evidence of sclerosis as seen in this case. Sclerosis is seen as “white patches” on the ear drum. It can often be quite extensive. Generally, there are no consequences to hearing. The area of sclerosis can change with time as the tympanic membrane is constantly evolving.

Here is the complete video exam:

Complete exam video