Clinical presentations Physical findings a Defect in the pars tensa of TM or the pars flaccida or both Atelectatic lesions in tensa or flaccida pars u Squamous epithelial invasion may invade middle ear Granumoms, polyps, tympanosclerotic plaques in middle earClinical presentations ◼ Physical findings ◼ Defect in the pars tensa of TM or the pars flaccida or both ◼ Atelectatic lesions in tensa or flaccida pars ◼ Squamous epithelial invasion may invade middle ear ◼ Granumoms, polyps, tympanosclerotic plaques in middle ear