Tympanoplasty for Bony Ossicular Fixation

Radiological and Audiological Prediction for Ossicular Fixation in Chronic Otitis Media and Tympanic Membrane Perforation

“…We presume that the density and location of the fibrous or granulation tissue surrounding the malleus determine the severity of malleus fixation. Histological studies have revealed that inflammation in the middle ear can lead to not only neo-osteogenesis in the walls of the attic but also postinfectious sclerotic and hyaline degeneration of the submucosal collagen layer or the ligaments (29)(30)(31)(32). Although such degeneration may limit malleal mobility in the early phases of COM, it is not visible as bony Copyright © 2021 Otology & Neurotology, Inc.…”

“…It begins with fibroblastic invasion of the submucosal layers, which subsequently thicken and fuse into a homogenous mass, with deposition of calcium and phosphate crystals (32). This process also involves the stapes or stapedial tendon (29,45). Concerning the soft tissue surrounding the stapes, fixation caused by fibrous tissue (not calcification) can occur anywhere in the middle ear; however, the anterior or superior regions of the oval window are susceptible to fixation, resulting in stapes ankylosis (33).…”

“…We presume that the density and location of the fibrous or granulation tissue surrounding the malleus determine the severity of malleus fixation. Histological studies have revealed that inflammation in the middle ear can lead to not only neo-osteogenesis in the walls of the attic but also postinfectious sclerotic and hyaline degeneration of the submucosal collagen layer or the ligaments (29–32). Although such degeneration may limit malleal mobility in the early phases of COM, it is not visible as bony density on CT. Contrarily, the location of such inflammation increases the probability of the malleus head becoming fixed to the anterior or lateral walls of the attic by postinfectious neo-osteogenesis, hyalinization, or calcification of the anterior malleal ligament (33–36).…”

Radiological and Audiological Prediction for Ossicular Fixation in Chronic Otitis Media and Tympanic Membrane Perforation

“…We presume that the density and location of the fibrous or granulation tissue surrounding the malleus determine the severity of malleus fixation. Histological studies have revealed that inflammation in the middle ear can lead to not only neo-osteogenesis in the walls of the attic but also postinfectious sclerotic and hyaline degeneration of the submucosal collagen layer or the ligaments (29)(30)(31)(32). Although such degeneration may limit malleal mobility in the early phases of COM, it is not visible as bony Copyright © 2021 Otology & Neurotology, Inc.…”

“…It begins with fibroblastic invasion of the submucosal layers, which subsequently thicken and fuse into a homogenous mass, with deposition of calcium and phosphate crystals (32). This process also involves the stapes or stapedial tendon (29,45). Concerning the soft tissue surrounding the stapes, fixation caused by fibrous tissue (not calcification) can occur anywhere in the middle ear; however, the anterior or superior regions of the oval window are susceptible to fixation, resulting in stapes ankylosis (33).…”

“…We presume that the density and location of the fibrous or granulation tissue surrounding the malleus determine the severity of malleus fixation. Histological studies have revealed that inflammation in the middle ear can lead to not only neo-osteogenesis in the walls of the attic but also postinfectious sclerotic and hyaline degeneration of the submucosal collagen layer or the ligaments (29–32). Although such degeneration may limit malleal mobility in the early phases of COM, it is not visible as bony density on CT. Contrarily, the location of such inflammation increases the probability of the malleus head becoming fixed to the anterior or lateral walls of the attic by postinfectious neo-osteogenesis, hyalinization, or calcification of the anterior malleal ligament (33–36).…”

Malleus head fixation: histopathology revisited

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Radiological and Audiological Prediction for Ossicular Fixation in Chronic Otitis Media and Tympanic Membrane Perforation

“…We presume that the density and location of the fibrous or granulation tissue surrounding the malleus determine the severity of malleus fixation. Histological studies have revealed that inflammation in the middle ear can lead to not only neo-osteogenesis in the walls of the attic but also postinfectious sclerotic and hyaline degeneration of the submucosal collagen layer or the ligaments (29)(30)(31)(32). Although such degeneration may limit malleal mobility in the early phases of COM, it is not visible as bony Copyright © 2021 Otology & Neurotology, Inc.…”

“…It begins with fibroblastic invasion of the submucosal layers, which subsequently thicken and fuse into a homogenous mass, with deposition of calcium and phosphate crystals (32). This process also involves the stapes or stapedial tendon (29,45). Concerning the soft tissue surrounding the stapes, fixation caused by fibrous tissue (not calcification) can occur anywhere in the middle ear; however, the anterior or superior regions of the oval window are susceptible to fixation, resulting in stapes ankylosis (33).…”

“…We presume that the density and location of the fibrous or granulation tissue surrounding the malleus determine the severity of malleus fixation. Histological studies have revealed that inflammation in the middle ear can lead to not only neo-osteogenesis in the walls of the attic but also postinfectious sclerotic and hyaline degeneration of the submucosal collagen layer or the ligaments (29–32). Although such degeneration may limit malleal mobility in the early phases of COM, it is not visible as bony density on CT. Contrarily, the location of such inflammation increases the probability of the malleus head becoming fixed to the anterior or lateral walls of the attic by postinfectious neo-osteogenesis, hyalinization, or calcification of the anterior malleal ligament (33–36).…”

Malleus head fixation: histopathology revisited

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Radiological and Audiological Prediction for Ossicular Fixation in Chronic Otitis Media and Tympanic Membrane Perforation

“…We presume that the density and location of the fibrous or granulation tissue surrounding the malleus determine the severity of malleus fixation. Histological studies have revealed that inflammation in the middle ear can lead to not only neo-osteogenesis in the walls of the attic but also postinfectious sclerotic and hyaline degeneration of the submucosal collagen layer or the ligaments (29)(30)(31)(32). Although such degeneration may limit malleal mobility in the early phases of COM, it is not visible as bony Copyright © 2021 Otology & Neurotology, Inc.…”

“…It begins with fibroblastic invasion of the submucosal layers, which subsequently thicken and fuse into a homogenous mass, with deposition of calcium and phosphate crystals (32). This process also involves the stapes or stapedial tendon (29,45). Concerning the soft tissue surrounding the stapes, fixation caused by fibrous tissue (not calcification) can occur anywhere in the middle ear; however, the anterior or superior regions of the oval window are susceptible to fixation, resulting in stapes ankylosis (33).…”

“…We presume that the density and location of the fibrous or granulation tissue surrounding the malleus determine the severity of malleus fixation. Histological studies have revealed that inflammation in the middle ear can lead to not only neo-osteogenesis in the walls of the attic but also postinfectious sclerotic and hyaline degeneration of the submucosal collagen layer or the ligaments (29–32). Although such degeneration may limit malleal mobility in the early phases of COM, it is not visible as bony density on CT. Contrarily, the location of such inflammation increases the probability of the malleus head becoming fixed to the anterior or lateral walls of the attic by postinfectious neo-osteogenesis, hyalinization, or calcification of the anterior malleal ligament (33–36).…”

Malleus head fixation: histopathology revisited

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