Symmetrically dotted tympanic membranes.

KEY CLINICAL MESSAGE: Color changes of the tympanic membranes without an inflammatory component or perforation are rarely described. They may result from hemorrhage after barotrauma or spontaneously. Other explanatory models include discoloration due to otomycosis.

ABSTRACT: This is a case of a 61-year-old patient with an unexplained incidental of black dots located almost symmetrically on the antero-inferior quadrant of both tympanic membranes. This harmless anatomical rarity has not been published before. Underlying pathologies should be excluded in the case of discoloration of the tympanic membranes.