Overview of Myringosclerosis and Tympanosclerosis

Earache
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Myringosclerosis and tympanosclerosis are similar conditions which affect the middle ear, causing the eardrum to appear bright white. The whiteness is due to calcium deposits which form on the tympanic membrane, which is more commonly called the eardrum. The only difference between myringosclerosis and tympanosclerosis is that in myringosclerosis the calcium deposits, the calcium only deposits on the eardrum. Myringosclerosis does not have any symptoms like in tympanosclerosis, where the calcium deposits not only on the eardrum but also onto the structures of the middle ear. Tympanosclerosis can cause symptoms such as hearing loss. While scar tissue can have a similar appearance to these conditions, it is not the same.

What Causes Myringosclerosis and Tympanosclerosis?

In myringosclerosis and tympanosclerosis, the calcium deposits are thought to form when the body's normal healing response goes awry. In fact, some medical researchers consider myringosclerosis and tympanosclerosis autoimmune diseases. In addition to forming calcium deposits, the eardrum, which is normally thin and translucent, may thicken, harden, and lose its transparency and mobility. This is thought to be caused by chronic inflammation in the middle ear which produces extra tissue cells. Conditions are known to contribute to the development of myringosclerosis and tympanosclerosis include:

Symptoms

Myringosclerosis causes no symptoms. The most common symptom of tympanosclerosis is conductive hearing loss. Depending on the situation, hearing loss can often be completely reversed or will at least significantly improve with treatment.

How Are Myringosclerosis and Tympanosclerosis Diagnosed?

These conditions are best diagnosed by a doctor called an otolaryngologist who specializes in diagnosing and treating disorders of the ear, nose, and throat. Your doctor will consider your medical history, including any history of fluid in the ears, infections, or surgeries which may contribute to developing myringosclerosis or tympanosclerosis. Next, your doctor will most likely examine your ears using an otoscope. An otoscope is a tool that is inserted into your ear canal and allows the doctor to view your eardrum. It is not uncomfortable. If white patches or thickening of the eardrum are seen your doctor may use some of the following tests to confirm a diagnosis:

  • Hearing tests: conductive hearing loss may indicate tympanosclerosis.
  • Tympanometry: this test is performed using a device called a tympanometer. A tympanometer looks and feels like an otoscope but unlike an otoscope, it is used to deliver sound waves into the middle ear. These sound waves should bounce off of the eardrum and their return is charted as a graph called a tympanogram. A flat tympanogram can indicate a rigid, un-mobile eardrum. This test can give false results if you talk, swallow, yawn, sneeze, or open your mouth during the test.

Treatment

Since myringosclerosis is asymptomatic it requires no treatment. Tympanosclerosis may require treatment if hearing loss is significant. The only treatment for tympanosclerosis is surgery to repair the eardrum and any other middle ear structures involved. During surgery, your surgeon will remove the hardened (sclerotic) portions of the eardrum and may have to also perform surgery on any of the bones of the middle ear (ossicular chain).

A potential problem is a fixed stapes (3rd bone in the middle ear), which without movement, sound cannot be created. In these circumstances, a stapesplasty, or insertion of a prosthetic stapes is performed. If the hearing loss does not completely resolve following the surgery, a device such as a hearing aid may be helpful.

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