Picture of a central left tympanic membrane perforation.
In general, such perforations are caused by chronic suppurative otitis media. In addition to hearing loss, patients present with purulent drainage that subsides on antibiotic treatment. The perforation is then patched with a temporalis fascia graft (tympanoplasty).
Picture of left tympanic membrane perforation
This dry perforation in the posteroinferior quadrant has ragged edges and to a certain extent, resembles traumatic perforations. The fragment of skin hanging in the center of the perforation was pulled out of the middle ear, where it was forming a cholesteatoma sac.
Picture of right inferior tympanic membrane perforation.