The aim of the study was to assess the degree of conductive hearing loss in relation to sites of tympanic membrane perforation in inactive mucosal variety of chronic otitis media and to determine the degree of conductive hearing loss related to different sizes of tympanic membrane perforation.
There is a typical history of recurrent middle ear infections which cause persistent foul-smelling ear discharge, hearing loss and tympanic membrane perforation. The diagnosis of cholesteatoma is usually made on otologic examination2.
These include cotton wool swab collection of discharge from the external auditory canal, needle aspiration of the middle ear (tympanocentesis), and suction aspiration of the discharge from the middle ear through the tympanic membrane perforation.  The best method is tympanocentesis from the intact tympanic membrane; but it loses its utility once the tympanic membrane ruptures and the discharge from middle ear comes in external auditory canal.
Twelve (30%) patients had large size, 24(60%) medium size, one (2.5%) pin hole size and 3(7.5%) had subtotal tympanic membrane perforation. Fourteen (35%) patients had anterio-inferior perforation, 22(55%) had central, and 4(10%) had posterior-inferior perforation of tympanic membrane.