Description
Case I
Case II
Case III


Description

Normal tympanic membrane is a pearly-gray color with barely visible small blood vessels, especially on the handle of the malleus. Tympanic membrane can be slightly transparent but also matte and opaque. Tympanic membrane consists of two major parts: pars tensa and pars flaccida which is thinner and – unlike pars tensa – has no fibrous layer. The thickness is approximately 0.1 mm.

(Based on: A. Bochenek, M. Reicher Anatomia człowieka. tom V. PZWL, Warszawa 1989. ISBN 978-83-200-3848-4)


Case I

Picture below: right ear: this is a picture of normal tympanic membrane. The handle of the malleus and umbo (tip of the malleus, white central point) are very well visible. The tympanic membrane is slightly transparent. There are small vessels going along the handle of the malleus to umbo and radiating outwards reaching the outer parts of the tympanic membrane. A cone of light can be seen from the umbo to the antero-inferior quadrant (fig. 1 & 1a).

Normal tympanic membrane
Fig. 1 Normal tympanic membrane
Normal tympanic membrane - scheme
Fig. 1a Normal tympanic membrane – scheme
  1. malleus handle
  2. malleus tip (umbo)
  3. cone of light
Quadrants of tympanic membrane
Fig. 1b Quadrants of tympanic membrane
  • A – S – antero – superior
  • A – I – antero – inferior
  • P – S – postero – superior
  • P – I – postero – inferior

Case II

Left ear: this is a picture of normal tympanic membrane. The handle of the malleus and umbo (tip of the malleus, white central point) are very well visible. The tympanic membrane is slightly transparent only in antero-superior quadrant. There are small vessels going along the handle of the malleus to umbo and radiating outwards reaching the outer parts of the tympanic membrane. The rest of the tympanic membrane is opaque and has milky colour. Middle ear structures, like incudostapedial joint, promontory or chorda tympani are invisible. A small cone of light can be seen in posterior quadrant. This is a picture of the child with normal tympanometry and tonal audiometry, without history of ear infections (fig. 2).

Normal tympanic membrane
Fig. 2 Normal tympanic membrane

Case III

Left ear: this is a picture of normal tympanic membrane. The handle of the malleus and umbo (tip of the malleus, white central point) are very well visible. The tympanic membrane is transparent. There are small vessels going along the handle of the malleus to umbo and radiating outwards reaching the outer parts of the tympanic membrane. A cone of light can be seen from the umbo to the antero-inferior quadrant. The umbo is pulled while posterior quadrant is slightly bulging but the tension and structure of the tympanic membrane are normal. This is a picture of the child with normal tympanometry and tonal audiometry, without history of ear infections (fig. 3).

Normal tympanic membrane
Fig. 3 Normal tympanic membrane