Which condition is characterized by an opaque, white, and chalky appearance of the tympanic membrane?

Tympanosclerosis is characterized by the presence of a white, chalky appearance of the tympanic membrane (eardrum) due to the deposition of calcium carbonate and other minerals in the tissue. This condition often occurs as a result of chronic inflammation or recurrent ear infections, leading to scarring and thickening of the eardrum. The changes associated with tympanosclerosis give the membrane a distinctive opaque appearance.

In contrast, otosclerosis typically involves the footplate of the stapes bone in the middle ear and is associated with conductive hearing loss without the characteristic tympanic membrane changes seen in tympanosclerosis. Cholesteatoma refers to the abnormal skin growth in the middle ear, which can lead to more significant issues but does not produce the same visible changes on the tympanic membrane's surface. Lastly, a fistula usually refers to an abnormal connection between the middle ear and the inner ear and does not specifically affect the appearance of the tympanic membrane like tympanosclerosis does.