Article

Tympanosclerosis in the Rat Tympanic Membrane: An Experimental Study

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John D. Russell FRCS (ORL)1,*, J. J. Giles PhD2 Article first published online: 2 JAN 2009 DOI: 10.1097/00005537-200209000-00025
Copyright 2002 The Triological Society

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The Laryngoscope Volume 112, Issue 9, pages 16631666, September 2002

American Journal of Otology: September 2000 - Volume 21 - Issue 5 - pp 631-635 Middle Ear and Mastoid Disease

Surgical Treatment of Tympanosclerosis

Albu, S.; Babighian, G.; Trabalzini, F.

Abstract
Objective: To report the hearing results of the surgical treatment of tympanosclerosis. Study Design: A retrospective review of surgically treated cases of tympanosclerosis. Setting: A tertiary referral center. Patients: One hundred fifteen patients with middle ear tympanosclerosis operated on between 1987 and 1996, with an average age of 36 years (range 18-59 years). Cases were classified into four groups according to Wielinga and Kerr. Those with an associated cholesteatoma were excluded.

Intervention: Depending on the ossicular status, either mobilization of the major ossicles or epitympanic bypass procedure, mobilization of the stapes or stapedectomy. Main Outcome Measures: The postoperative pure-tone average was compared with the preoperative levels by use of conventional audiometry. The air-bone gap was measured. Results: The average postoperative air-bone gap was 18.0 10.21 dB in the type II group (attic fixation of the malleus-incus complex with a mobile stapes), 21.8 9.5 dB in the type III group (mobile malleus-incus complex, if present, with stapes footplate fixation), and 22.92 10.03 dB in the type IV group (fixation of both the stapes footplate and the malleus-incus complex). Patients with a fixed malleus and mobile stapes had significantly better hearing results than those with stapes fixation (p = 0.042, Mann-Whitney U test). Conclusion: In ossicular attic fixation, atticotomy and mobilization of ossicles yielded better results than did the epitympanic bypass procedure. The difference, however, did not reach statistical significance. Patients with fixed stapes treated with stapedectomy displayed good hearing results immediately after surgery, but the air-bone gap deteriorated after some time. 2000, The American Journal of Otology, Inc.

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Acta Otolaryngol. 2004 Jun;124(5):574-6.

Possible relationship between tympanosclerosis and atherosclerosis.

Pirodda A, Ferri GG, Bruzzi C, Marini M, Faggioli G.

Source
Department of Surgical and Anaesthesiological Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. [email protected]

Abstract
OBJECTIVE:
In order to confirm a possible link, as suggested by a recent study, between atherosclerosis and tympanosclerosis, and which could theoretically open new frontiers in the early diagnosis of vascular atherosclerotic diseases starting from a rather simple and rapid examination such as otoscopy, we further investigated this hypothesis in a population affected by atherosclerotic disease of the carotid artery.

MATERIAL AND METHODS:

Fifty patients submitted to carotid endarterectomy were examined. Patients with a history of previous otologic diseases or otosurgical procedures were excluded. The presence of tympanosclerosis was defined if at least 20% of the eardrum was affected by tympanic plaques. The study group was compared to a sexand age-matched control group randomly chosen from our hospital with a negative history of vascular and otologic diseases.

RESULTS:
Tympanosclerosis was observed in 18/50 patients (36%) in the study group, compared to 6/50 cases in the control group (12%). This difference was statistically significant (p = 0.005). In both groups the incidence of this finding was similar for both sexes.

CONCLUSIONS:
Our results confirm the reported analogies between tympanosclerosis and atherosclerosis. Although further investigations are needed, promising implications can be predicted for the diagnostic and therapeutic evaluation of this kind of ear patient.

PMID: 15267174 [PubMed - indexed for MEDLINE] J Laryngol Otol. 1999 Dec;113(12):1076-80.

Tympanosclerosis: review of literature and incidence among patients with middle-ear infection.
Asiri S, Hasham A, al Anazy F, Zakzouk S, Banjar A.

Source
Department of ENT, Security Forces Hospital, Madina, Saudi Arabia.

Abstract
The aim of the study was to review the literature of tympanosclerosis especially its pathogenesis, to study the general incidence of tympanosclerosis among patients with chronic suppurative otitis media (CSOM), its association with cholesteatoma and also the type of hearing loss as well as its relation to the degree and site of tympanosclerosis. Seven hundred and seventy-five patients with CSOM were studied retrospectively. A full history was taken and thorough ENT examinations were carried out. Pure tone audiograms (PTA) of all patients were done and analysed. The operative finding of tympanosclerosis as well as middle-ear status were inspected. The incidence of tympanosclerosis was found to be 11.6 per cent (90 patients out of 775 CSOM cases). Most tympanosclerosis cases had dry ear, (85.6 per cent). Of the 57.8 per cent who had myringosclerosis, their PTA showed an AB gap 20-40 dB. When sclerosis affect both the tympanic membrane and middle ear, 61 per cent of patients had an AB gap > 40 dB. The association of cholesteatoma and tympanosclerosis may be regarded as uncommon, 2.2 per cent. The exact aetiology and pathogenesis of tympanosclerosis is as yet not well known. Our study concentrated on the clinical picture of tympanosclerosis among patients with CSOM. The majority of hearing loss associated with tympanosclerosis was of the conductive type.

PMID: 10767919 [PubMed - indexed for MEDLINE]

Tympanosclerosis
R. B. JOSEPH, M.D.; J. GORDON, M.D. Arch Otolaryngol. 1963;77(2):186-190.

Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. Tympanosclerosis is a rather common sequel to otitis media. The clinical history, appearance, and differential diagnosis of tympanosclerosis have been excellently described in recent articles by House1 and Harris2; however, the histopathogenesis and management are still disputed.1-4 Zollner3 and House1 feel that tympanosclerosis is an end-result of chronic or repeated middle ear infections and does not recur after operative removal. It is the opinion of Brockman4 that tympanosclerosis is an active, bone-destroying process and, as such, is a contraindication to tympanoplasty. Harris2 attempts to divide tympanosclerosis into 2 categories, i.e., a benign "sclerosing mucositis" and an invasive "osteoclastic mucoperiositis." Two cases of rather severe tympanosclerosis which illustrate different principles of surgical management are presented. Representative histopathologic sections of the tympanosclerosis removed at the time of surgery from Case 1 are also illustrated and described.

The Journal of Laryngology & Otology

The Journal of Laryngology & Otology (1999), 113: 1076-1080 Copyright JLO (1984) Limited 1999 DOI: 10.1017/S0022215100157937 (About DOI) Published online: 2007 New Content Alerts Journal Widget About Widget Rss Atom

Table of Contents - 1999 - Volume 113, Issue 12

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Main Articles Tympanosclerosis: review of literature and incidence among patients with middle-ear infection

Saad Asiria1, Alaa Hashama1, Fatma Al Anazya2 c1, Siraj Zakzouka1 and Adel Banjara3
a1

Departments of ENT, Security Forces Hospital, Madina, Saudi Arabia. Departments of ENT, King Abdul Aziz University Hospital, Madina, Saudi Arabia. Departments of ENT, Riyadh, and Ohud Hospital, Madina, Saudi Arabia.

a2

a3

Abstract The aim of the study was to review the literature of tympanoscierosis especially its pathogenesis, to study the general incidence of tympanoscierosis among patients with chronic suppurative otitis media (CSOM), its association with cholesteatoma and also the type of hearing loss as well as its relation to the degree and site of tympanosclerosis. Seven hundred and seventy-five patients with CSOM were studied retrospectively. A full history was taken and thorough ENT examinations were carried out. Pure tone audiograms (PTA) of all patients were done and analysed. The operative finding of tympanosclerosis as well as middle-ear status were inspected. The incidence of tympanosclerosis was found to be 11.6 per cent (90 patients out of 775 CSOM cases). Most tympanosclerosis cases had dry ear, (85.6 per cent). Of the 57.8 per cent who had myringosclerosis, their PTA showed an AB gap 2040 dB. When sclerosis affect both the tympanic membrane and middle ear, 61 per cent of patients had an AB gap >40 dB. The association of cholesteatoma and tympanosclerosis may be regarded as uncommon, 2.2 per cent. The exact aetiology and pathogenesis of tympanosclerosis is as yet not well known. Our study concentrated on the clinical picture of tympanosclerosis among patients with CSOM. The majority of hearing loss associated with tympanosclerosis was of the conductive type. (Accepted August 24 1999) Key words

Vol. 72 No. 3, September 1960

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Tympanosclerosis
This Article WILLIAM F. HOUSE, M.D.; JAMES L. SHEEHY, M.D. Arch Otolaryngol. 1960;72(3):308-313.
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Since this article does not have an have provided the first 150 words of the full text PDF and any section headings. Citing Articles

Science (29) Tympanosclerosis is the term used to describe a sclerotic or hyalin change in the mucous membrane of the middle ear and Contact me when this article is cited mastoid. Although tympanosclerotic changes in the eardrum have been recognized for years and called chalk spots, calcific plaques, or atheromatous plaques, it was not until recently Related Content that the clinical significance of these lesions was recognized. Similar articles in this journal This was brought about by the interest in reconstructive middle ear surgery. It is important that every otologist be aware of the condition and its pathogenesis and appreciate Social that it must be differentiated from the much more common Bookmarking conditionscholesteatoma and otosclerosis which it may mimic. It was with this in mind and to point out how What's this? tympanosclerosis should be handled that this paper was written.

Citing articles on Web of

According to Zllner,1 "sclerosis of the tympanum tissue" was first described by Von Trltsch in 1873. Zllner noted that the mucosa of the tympanic cavity became more dense, . . . [Full Text PDF of this Article

Eur Arch Otorhinolaryngol. 2010 May;267(5):673-7. Epub 2009 Sep 22.

Tympanosclerosis and our surgical results.

Aslan H, Katilmi H, Oztrkcan S, Ilknur AE, Baolu S.

Source
Department of Otorhinolaryngology and Head and Neck Surgery, Atatrk Research and Training Hospital, Ministry of Health, Izmir, Turkey. [email protected]

Abstract
Tympanosclerosis is a sequel of chronic otitis media characterized by the deposition of calcareous plaques following hyaline degeneration in the fibrous layer of the tympanic membrane and inside middle ear mucosa.

It usually results from prior middle ear infections. In this study, results of treatment and clinical findings of the patients with tympanosclerosis are presented. Our objective is to determine the changes in middle ear caused by tympanosclerosis and intervene in the more problematic zone and find out the more useful treatment protocol for patients. Preoperative features, middle ear findings detected during surgery and postoperative hearing levels of the patients who were operated in our clinic between January 1996 and June 2006 due to tympanosclerosis were evaluated. Surgical treatment was performed on a total of 37 patients including 25 females and 12 males between ages of 11 and 71. Preoperative tympanic membranes perforations were presented at a rate of 91% and average airway bone gap was 37.8 dB. Bilateral involvement was present in 59%. Conductive-type hearing loss was present at a rate of 81%, whereas mixed-type hearing existed at a rate of 19%. Sclerotic plaques were most commonly localized in the attic with a rate of 72%. Post-op outcome was found to be 27% in the patients with air bone gap between 0-20 dB. The best hearing result belonged to type 1 patients. Cases in which stapes footplate was fixated had the worst result in terms of hearing. Teflon piston was only applied in one patient. Our tympanoplasty success was found to be 67%. The most common treatment method of tympanosclerosis is surgery. Stapedectomy is recommended in surgery instead of mobilization techniques. However, there is often recurrence and there is no curative treatment. Therefore rehabilitation with hearing device can be preferred as an adjunct. In the recent experimental studies, good results with topical or systemic agents have also been promising.

Acta Otolaryngol. 2010 Mar;130(3):370-4.

Clinical analysis of intratympanic tympanosclerosis: etiology, ossicular chain findings, and hearing results of surgery.
Ho KY, Tsai SM, Chai CY, Wang HM.

Source
Department of Otolaryngology, Kaohsiung Medical University Hospital, Taiwan.

Abstract
CONCLUSION:
The success rate (57.5%) in this study is not high for surgical treatment of tympanosclerosis, and therefore lends further evidence that intratympanic tympanosclerosis has been considered intractable for reconstructive surgery.

OBJECTIVE:
To investigate the clinical findings and surgical results of intratympanic tympanosclerosis.

METHODS:
From January 1989 to December 2006, a total of 1523 tympanoplasties were performed. Of these, 84 tailored tympanomastoidectomies were performed for tympanosclerosis in 80 patients.

RESULTS:
The incidence of intratympanic tympanosclerosis with chronic ear disease was 5.5%. Chronic otitis media was the most common etiologic factor for the tympanosclerosis (79 ears, 94.1%). Tympanosclerosis in the middle ear cavity was most often found around the malleus handle (67 ears, 79.8%), and more than half of the cases of tympanosclerosis (43 ears, 51.2%) had multiple areas affected by the sclerotic tissue. Tympanosclerotic fixation of the stapes was found in 31 ears (36.9%), and an intact ossicular chain was seen in 57 ears (67.9%). There was a postoperative improvement in hearing in 42 ears (57.5%).

PMID: 19685361 [PubMed - indexed for MEDLINE]

Acta Otolaryngol Suppl 130(3):370-4 (2010) Clinical analysis of intratympanic tympanosclerosis: etiology, ossicular chain findings, and hearing results of surgery. Kuen-Yao Ho, Shih-Meng Tsai, Chee-Yin Chai and Hsun-Mo Wang Department of Otolaryngology, Kaohsiung Medical University Hospital. AbstractBuy the PDF

Pubmed abstract Get permission Buy the PDF PDF from publisher Suppl. info HTML version PMID: 19685361

Abstract Conclusion: The success rate (57.5%) in this study is not high for surgical treatment of tympanosclerosis, and therefore lends further evidence that intratympanic tympanosclerosis has been considered intractable for reconstructive surgery. Objective: To investigate the clinical findings and surgical results of intratympanic tympanosclerosis. Methods: From January 1989 to December 2006, a total of 1523 tympanoplasties were performed. Of these, 84 tailored tympanomastoidectomies were performed for tympanosclerosis in 80 patients. Results: The incidence of intratympanic tympanosclerosis with chronic ear disease was 5.5%. Chronic otitis media was the most common etiologic factor for the tympanosclerosis (79 ears, 94.1%). Tympanosclerosis in the middle ear cavity was most often found around the malleus handle (67 ears, 79.8%), and more than half of the cases of tympanosclerosis (43 ears, 51.2%) had multiple areas affected by the sclerotic tissue. Tympanosclerotic fixation of the stapes was found in 31 ears (36.9%), and an intact ossicular chain was seen in 57 ears (67.9%). There was a postoperative improvement in hearing in 42 ears (57.5%). DOI: