Chalky white tympanic membrane is seen in:
Keratosis Obturans (Primary canal cholesteatoma)It is accumulation of a large plug of desquamated keratin in the external auditory meatusSeen between 5 and 20 yrs of age (i.e. younger age as compared to cholestealoma which is seen in middle age)May be U/L or Bilateral (occasionally)It may be associated with bronchiectasis and chronic sinusitis.Clinical FeaturesPain in the ear (severe olatagia)Hearing loss (of conductive type)TinnitusEar discharge - sometimesPearly white mass of keratin is visible in the ear canalTympanic membrane is thickened and chalky white in appearanceEar canal is balloonedTreatmentRemoval by syringing / InstrumentationPeriodic checkup should be done to see reaccumulationIf it recurs - keratolytic agent - 2% salicylic acid in alcohol can be tried.
ASOM
Otosclerosis
Tympanosclerosis
Cholesteatoma