Myringosclerosis and Tympanosclerosis Hearing Loss

Hardening of the Ear Drum and Structures of the Middle Ear

Anatomy of the ear
Anatomy of the ear. A.D.A.M.

What are Myringosclerosis and Tympanosclerosis?

Myringosclerosis and tympanosclerosis are similar conditions which affect the middle ear. While the exact pathology of the conditions are not completely understood, both are characterized by healthy tissue degeneration and calcium deposits which form on the tympanic membrane, (more commonly called the eardrum). The only difference between myringosclerosis and tympanosclerosis is that in myringosclerosis the calcium deposits, which appear as white patches on the ear drum, are only on the ear drum and do not cause symptoms.

Tympanosclerosis occurs when calcium deposits cause symptoms such as hearing loss and may spread to other areas of the middle ear beyond the tympanic membrane. 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 ear drum, 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:

  • chronic fluid in the ear, also called otitis media with effusion (OME), serous otitis media (SOM) and glue ear

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 ear drum. 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 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 ear drum and their return is charted as a graph called a tympanogram. A flat tympanogram can indicate a rigid, un-mobile ear drum. 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 ear drum and any other middle ear structures involved. During surgery, your surgeon will remove the hardened (sclerotic) portions of the ear drum 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 can not be created. In these circumstances, a stapesplasty, or insertion of a prosthetic stapes is performed. If a hearing loss does not completely resolve following the surgery, a device such as a hearing aid may be helpful.

    Sources:

    Family Practice Notebook. Myringosclerosis. Accessed: January 27, 2014 from http://www.fpnotebook.com/ent/ear/myrngsclrs.htm

    The Hearing Journal. Through the Otoscope: The mysterious tympanosclerosis. Accessed: January 27, 2014 from http://journals.lww.com/thehearingjournal/Fulltext/2012/01000/Through_the_Otoscope__The_mysterious.5.aspx

    Medscape. Tympanosclerosis and our surgical results. Accessed: January 27, 2014 from http://reference.medscape.com/medline/abstract/19771442

    Otologytextbook.com. Tympanosclerosis. Accessed: January 27, 2014 from http://otologytextbook.net/tympanosclerosis.htm

    Gurr, A., Hildmann, H., Stark, T. & Dazert, S. Treatment of Tympanosclerosis. Accessed: January 27, 2014 from http://www.ncbi.nlm.nih.gov/pubmed/18483716

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