In general, perforations can be divided into central or marginal. Central perforations maintain a margin of drum remnant around the circumference of the perforation. Typically, these perforations only intermittently drain and are not associated with choles-teatoma. Marginal perforations involve the periphery of the TM. They are most often located in the posterior-superior quadrant or in the pars flaccida; present with persistent, malodorous discharge; and frequently involve cholesteatoma.
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