Ca-wheel appearance of tympanic membrane in ASOM is due to
Perforation of tympanic membrane
Edema of tympanic membrane
Congested blood vessels along malleus
Granulation tissue on tympanic membrane
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)
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