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 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.

Consanguineous marriage is a tradition which is commonly practised among Asian, African, and Latin American communities whether they are living in their own countries or settled in Europe or the USA. These communities, in addition to their custom of interrelated marriage, have large families and are a rapidly growing population. The siblings of consanguineous marriages have a significantly higher incidence of autosomal recessive diseases including hearing impairment. Two epidemiological surveys were carried out 10 years apart. There were 6,421 subjects from Riyadh City and 9,540 from all other parts of the Kingdom of Saudi Arabia. A random sample was examined otologically and a questionnaire was filled in that included age, sex, family relation, number of siblings, etc. ENT examination and audiological assessment were performed. Consanguinity was found among 22 per cent as first cousins and 23 per cent as second cousins in the first survey. In the second survey 19 per cent were first cousins and 28 per cent second cousins. The rate of consanguinity was 45 per cent in the first survey and 47 per cent in the second. The prevalence of hereditary sensorineural hearing loss (SNHL) was 66.07 per cent and 36.6 per cent in the first and second survey respectively. The incidence of hereditary hearing impairment is very high in developing countries compared to developed countries. Prevention is essential to reduce the incidence of genetic hearing loss. Consanguinity should be discouraged through health education of the public about the adverse effect of interrelated marriage. Genetic counselling, premarital and antenatal screening are to be applied whenever possible, at least for those at risk of developing genetic diseases including hearing impairment.

Hereditary sensorineural hearing loss is a preventive disease. A random sample survey of 6,421 Saudi infants and children was conducted to study the prevalence of consanguineous marriage and its effect on the prevalence of hereditary sensorineural hearing loss. First cousin consanguineous marriage was found among the parents of 21.1% of the children studied and second cousin consanguinity was present in 23%. The overall prevalence of hereditary sensorineural hearing loss was 1.7%. A higher prevalence of 2.8% of mis type of deafness was found among children of first cousin parents, compared with 1.6% among children of more distant consanguinity and 1.4% among non-consanguineous families' children. The study showed that consanguinity is widely practiced among the population surveyed and demonstrated a marked adverse effect on the incidence of hereditary sensorineural hearing impairment. Ann Saudi Med 1993;13(5):447-450.

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