<prompt> Tuberculous otitis media of the middle ear has all of the following except:-Multiple perforation are seenPale granulomas are seenATT should be staedPainful otorrrhea is seen  <response>: Tubercular Otitis Media-Presents with Chronic painless foul smelling otorrhea,Severe conductive type hearing loss out of propoion to symptoms, involvement of labyrinth can lead to SNHL, Facial nerve palsyOE- Multiple perforations in tympanic membrane followed by coalesce into single large perforation Sieve Like Tympanic Membrane, Characteristic of tuberculous otitis media, Middle ear and mastoid are filled with pale granulation tissue Treatment-ATT for Primary disease, Oral toilet, Mastoid surgery 