<prompt> Ca-wheel appearance of tympanic membrane in ASOM is due toPerforation of tympanic membraneEdema of tympanic membraneCongested blood vessels along malleusGranulation tissue on tympanic membrane  <response>: In the stage of presuppuration of ASOM, there is congestion of pars tensa. A leash of blood vessels appears along the handle of malleus and at the periphery of tympanic membrane impaing it a ca-wheel appearance. Ref: Textbook of diseases of ENT, Dhingra 7th edition; pg no 67 