Those accompanied by underlying processes can display many physical features. The tympanic membrane may become thickened secondary to inflammation. Tympanosclerosis refers to the deposition of hyalinized collagen in the middle layer of the membrane due to previous inflammation, and appears as thick white patches. A perforation, or hole in the membrane, can occur from trauma or from underlying disease such as chronic otitis media. The size of a perforation can vary considerably.
Most traumatic perforations heal without intervention.
If the perforation is seen early, the stellate edges may be uncurled and a paper patch placed over the hole. Ossicular dislocations and non-healing traumatic perforations require tympanoplasty. Myrinigitis indicates inflammation of the tympanic membrane. Although this can be seen with underlying disease, myrinigitis pertains to inflammation in which the membrane is primarily involved. In bullous myringitis, bleb formations can be seen on the membrane which contain serous fluid, blood, or both.