Tympanosclerosis and our surgical results

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.

Experience with the Vibrant Soundbridge RW-Coupler for round window Vibroplasty with tympanosclerosis

“…The rate of tympanosclerosis is reported to be 9–38% in chronic otitis media cases, with bilateral tympanosclerosis seen in about 50% of the patients [3]. Tympanosclerotic plaques are found in the attic and around the stapes, oval window, RW, and promontorium [3].…”

“…Tympanosclerotic plaques are found in the attic and around the stapes, oval window, RW, and promontorium [3]. The second most common site for sclerosis occurrence is the RW region, which is involved in 30% of clinical cases in histologic studies [4].…”

The epidemiology of tympanosclerosis in chronic otitis media patients in the Kars region of Turkey: The role of computerized temporal tomography in diagnosis of tympanosclerosis

“…Tympanosclerosis is described as an irreversible, though not immutable end result of any unresolved specific or nonspecific inflammatory disease of the middle ear, characterized by anatomical distortion resulting in functional impairment that is hearing loss of the conductive type (Pal et al 2005). Being more likely in cases with ossicular chain involvement, tympanosclerosis often results in distortion of sound transfer mechanism and thus leads to conductive hearing loss, depending on size and site of tympanosclerotic plaques (Asiri et al 1999;Aslan et al 2010).…”

“…Tympanosclerosis is a common sequela of chronic suppurative otitis media (CSOM), otitis media with effusion (OME) and recurrent otitis media (ROM) or treatments such as ventilation tube insertion or myringotomy (Asiri et al 1999;Aslan et al 2010).…”

“…However, etiology and pathogenesis of tympanosclerosis remains unclarified alongside the ongoing controversy regarding the role of surgical treatment and the choice of an optimal tympanoplasty approach in the management of hearing loss (Asiri et al 1999;Aslan et al 2010). In addition, estimating real incidence of tympanosclerosis is considered challenging due to discordance between clinical histological and surgical diagnosis methods (Aslan et al 2010).…”