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Quiz - Retractions

There is a lot of information here so please read the tutorial carefully before attempting to answer the questions. As in the quiz on perforations, you will pretend to be a surgeon faced with a patient with ear disease.


You will need to know about perforations as well so revise the tutorial on perforations before starting this one. Good luck.


1. A seven-year-old child presents with recurring ear discharge. It is foul smelling and she has some hearing problems too.

You examine the ear and clean it using dry mopping and suction under the microscope. Once it is clean you see this:

Describe the ear fully using correct terminology.


How can you tell if the drum is stuck to the promontory?



2. What is a Tos stage 4 retraction? Is it important?


3. Describe this ear.

4. All new cases of ear disease should have a hearing test. What do you think the hearing test will show in this case?


5. You have a patient who has a grade 2 Sade retraction. The drum lies on the incus but there is no hearing loss and the patient does not get problems with infection. What should you do?


6. Why should a Stage 4 Tos attic retraction be referred for surgery? (this needs some background reading)

7. Have a look at the image below. Please ignore the arrows. This patient had recurring ear discharge and hearing loss in the left ear. She had been suffering for a few years.

Describe what you see.

What type of hearing loss will she have?

How severe will the hearing loss be?


The other ear was normal and had no hearing loss so I performed a type 2 tympanoplasty on the patient. What does this mean?

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