Tympano sclerosis

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Overview

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.

Symptoms

The typical symptoms associated with tympanosclerosis are hearing loss and a chalky white appearance of the ear drum. In some cases, ear pain may also arise due to hardened calcified deposits blocking the tympanic membrane and hampering the ear muscles, bones and other internal structures.

Causes

Conditions wherein fluid deposits accumulate in the ears, such as otitis media, adhesive otitis/glue ear.

Severe middle ear infections.

Ruptured ear drum.

Surgery or invasive diagnostic procedures performed in the ears.

Risk factors

Patients with tympanosclerosis have high levels of homocysteine, low-density lipoprotein, total cholesterol and triglyceride. Children who have had a ventilation tube (grommet) inserted for otitis media with effusion have a higher risk of developing tympanosclerosis. This risk has been reported as 11-37%.

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Complications

Tympanosclerosis may cause ligamentous/tendinous calcification or ossification, which can fix an ossicle to the side of the tympanic cavity. This is usually a complication of chronic otitis media. After trauma, hemotympanum may calcify, which can lead to fixation of ossicles.

Prevention

Get treatment for middle ear infections. ...

Protect your ears during flight. ...

Keep your ears free of foreign objects. ...

Guard against explosive noise.