BACKGROUND AND OBJECTIVES: Tympanosclerosis is a nonspecific and irreversible result of chronic inflammation or infection of the middle ear. However, there remains disagreement about how best to surgically treat tympanosclerotic ossicular fixation, with the controversy over its management when stapes is involved. The aim of this study was to evaluate operative findings and hearing results of tympanosclerosis involving the ossicular chain, which in turn would establish better surgical treatment of tympanosclerotic ossicular fixation. SUBJECTS AND METHODS: In this prospective study conducted from Mar 2000 to Dec 2007, 38 patients with tympanosclerosis who had undergone surgical treatment were evaluated. The clinical and operational records and pre- and postoperative pure tone audiograms were reviewed. RESULTS: Operative findings showed stapes fixation is the most common. In 8 patients (21.1%), stapes was mobile, while, in the remaining 30 patients (78.9%), stapes fixation was found. In all cases with stapes fixation, stapes mobilization was possible. Following hearing result reporting guideline by the Korean Otological Society, the success rate of middle ear surgery was 68.4% (26 of 38 patients). In cases with stapes fixation, the success rate was 66.6% (20 of 30 patients), while, in cases with no stapes fixation, the success rate was 75.0% (6 of 8 patients). However, there was no statistical significance between the two groups. CONCLUSION: Stapes fixation was found in 78.9% of tympanosclerotic ossicular fixation. In management of tympanosclerotic stapes fixation, meticulous excision of tympanosclerotic plaques and removal of new bone formation around stapes footplate after adequate exposure could achieve a relatively good hearing result without stapes surgery.
Ear, Middle ; Hearing ; Humans ; Inflammation ; Myringosclerosis ; Ossicular Replacement ; Osteogenesis ; Prospective Studies ; Stapes ; Stapes Mobilization ; Stapes Surgery

OBJECTIVES: Myringosclerosis is an irreversible pathological healing mechanism of the tympanic membrane which can result in the formation of sclerotic plaques. Antioxidant treatment is a recognised prevention therapy and coenzyme Q10 (CoQ10), lycopene, and grape seed extract (GSE), were used in this manner. METHODS: Forty-four Wistar rats were used in this experiment, and, following myringotomies, the animals were randomly divided into four groups. CoQ10, lycopene or GSE was administered orally to the respective groups, starting from the day of surgery. Otomicroscopy examination was performed on the 14th day. All tympanic membrane lesions were evaluated and compared otomicroscopically and histopathologically. RESULTS: The otomicroscopy and histopathological findings, compared against a control (saline) group, showed the CoQ10, lycopene, and GSE groups had statistically significant differences of degree of sclerosis (P<0.001). CONCLUSION: CoQ10, lycopene, and GSE were compared against a saline group and their antioxidative and anti-inflammatory effects were similar. The formation of myringosclerotic plagues after experimental myringotomy in rats significantly decreased and diminished after systemic administration of the three different antioxidant supplements.
Animals ; Grape Seed Extract ; Myringosclerosis* ; Rats ; Rats, Wistar ; Sclerosis ; Tympanic Membrane

There are occasional complications after tympanostomy tube insertion due either to the operative procedure itself or to the anato-mical or physiological effects of the tubes. Hearing loss, persisting perforation, tympanosclerosis, atrophy, atelectasis, and the development of cholesteatoma have all been attributed to the tympanostomy tubes. The development of a secondary cholesteatoma at the site of the tube placement Grommet cholesteatoma- is a very uncommon complication. We report one case of cholesteatoma associated with tympanostomy tube insertion.
Atrophy ; Cholesteatoma* ; Hearing Loss ; Middle Ear Ventilation ; Myringosclerosis ; Pulmonary Atelectasis ; Surgical Procedures, Operative

PURPOSE: Tympanosclerosis is a common problem causing conductive hearing loss accompanied by chronic otitismedia. The purpose of this study was to evaluate the CT findings of tympanosclerosis, and correlate them with thesurgical findings. MATERIALS AND METHODS: The CT scans of 17 patients with surgically-proven tympanosclerosis andthose of a control group of 34 patients with nontympanosclerotic chronic otitis media were reviewed. According totheir location, they were assigned to one of three groups; tympanic membrane, epitympanum, or ossicles. RESULTS: Tympanosclerosis was found during surgery to be located in the tympanic membrane (n=11), the epitympanum (n=6), oraround the ossicles(n=8). Calcification of the tympanic membrane, ossicular thickening, narrowing of theepitympanum and calcification of the tympanic cavity occurred to a significant extent, and were more often afeature of tympanosclerosis than of nontympanosclerotic chronic otitis media (p <0.05). As an indicater of tympanicmembrane involvement, sensitivity and specificity of calcification of the tympanic membrane were 73% and 83%,respectively. As an indicator of ossicular involvement, the corresponding figures for ossicular thickening were50% and 93% ; as an indicator of involvement of the tympanic cavity (especially the epitympanum) the figures fornarrowing of the epitympanum and calcification of the tympanic cavity were 50% and 50% (respective sensitivities),and 89% and 93%(respective specificities). CONCLUSION: Tympanosclerosis usually appears on CT as ossicularthickening, narrowing of the epitympanum, calcification of the tympanic membrane and/or tympanic cavity. CT isvery helpful in evaluating ossicular involvement and determining the appropriate surgical treatment oftympanosclerosis.
Ear, Middle* ; Hearing Loss, Conductive ; Humans ; Myringosclerosis* ; Otitis Media ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Tympanic Membrane

OBJECTIVE: To investigate the effect of different malleus treatments on the postoperative efficacy in the tympanosclerosis patients receiving ossicular chain reconstruction. METHOD: Fifty-nine patients (62 ears) with tympanosclerosis were treated by ossicular chain reconstruction. All the patients were divided into three groups, including malleus removal group (A, 24 ears), retaining only the malleus handle group (B, 18 ears) and the intact malleus group (C, 20 ears). All the patients were followed up 3 months pre-operation, 3 months and 1 year post-operation by audiometric measurement (the average hearing threshold at 0.5, 1.0, 2.0 kHz HI). Tympanic membrane was examined by ear endoscope. RESULT: The pre-operation mean air bone gap (ABG) in these groups were 40.07 +/- 77.56 dB, 37.31 +/- 76.45 dB, and 36.75 +/- 76.72 dB, among which the difference had no statistical significance (P > 0.05). At 3 months after operation, the ABG in all cases was improved at 0.5, 1 and 2 kHz. The difference of ABG improvement among these three groups had no statistical significance (P > 0.05). One year after surgery, the ABG of the three groups were decreased by 17.92 +/- 9.28 dB, 16.76 +/- 5.19 dB and 10.58 +/- 7.38 dB respectively. The hearing improvement in group C is less than the other two groups (P = 0.03, P = 0.016). The difference of hearing improvement between group A and group B had no statistical significance(P > 0.05). Group A and group B each have one case of tympanic membrane perforation and artificial ossicle falling off. CONCLUSION The operating processes of malleus in ossicular chain reconstruction of patients with tympanosclerosis were introduced. In terms of short-term efficacy, the three groups showed no significant difference. However, the long-term efficacy of the patients in the group A and group B were better compared with the group C.
Adolescent ; Adult ; Female ; Humans ; Male ; Malleus ; surgery ; Middle Aged ; Myringosclerosis ; surgery ; Ossicular Replacement ; methods ; Retrospective Studies ; Treatment Outcome ; Young Adult

Tympanosclerosis is the middle ear tissue hyalinization and calcification caused by chronic middle ear inflammation, which mainly results in conductive deafness with unobvious clinical symptom. Etiology is unclear. The treatment is given priority to surgical treatment at present, while long-term effect reported mostly poor. This article analyzed etiology and treatment of the tympanic cavity sclerosis.
Calcinosis ; Chronic Disease ; Ear, Middle ; Hearing Loss, Conductive ; etiology ; Humans ; Myringosclerosis ; complications ; etiology ; therapy ; Otitis Media ; Sclerosis

Primary ciliary dyskinesia results in characteristic clinical symptoms, including chronic pansinusitis, recurrent infections of the respiratory tract, and infertility. Kartagener's syndrome is clinically distinguishable by the presence of situs inversus from this group of diseases. Other otolaryngological manifestations of primary ciliary dyskinesia which have been reported include otitis media with effusion, tympanosclerosis, keratosis obturans, and chronic cholesteatoma. Congenital nystagmus is another otological symptom characterized by ocular oscillation, which usually appears in the early infancy, and is often associated with visuosensory abnormalities. Recently, we experienced a 13 year-old boy with congenital nystagmus in addition to all other manifestations of Kartagener's syndrome. Although the clinical implication is not clear, it is possible that two diseases share the same developmental abnormality.
Adolescent ; Cholesteatoma ; Humans ; Infertility ; Kartagener Syndrome* ; Keratosis ; Male ; Myringosclerosis ; Nystagmus, Congenital* ; Otitis Media with Effusion ; Respiratory System ; Situs Inversus

Neuroglialchoristoma is a rare cerebral heterotopia typically involving extracranial midline structures of the head and neck, including the nose, nasopharynx and oral cavity. It rarely involves non-midline structures, such as the middle ear, mastoid and orbit. We report the case of a 63-year-old woman with right-sided hearing loss and aural fullness who was diagnosed with neuroglialchoristoma of the middle ear and mastoid. To our knowledge, this is the first report on neuroglialchoristomawith massive tympanosclerosis. The presence of combination supported the inhalation theory of neuroglialchoristoma, given that tympanosclerosis is typically caused by Eustachian tube dysfunction.
Choristoma* ; Ear, Middle* ; Encephalocele ; Eustachian Tube ; Female ; Head ; Hearing Loss ; Humans ; Inhalation ; Mastoid ; Middle Aged ; Mouth ; Myringosclerosis* ; Nasopharynx ; Neck ; Neuroglia ; Nose ; Orbit

PURPOSE: In order to determine specific differences, we compared the temporal bone CT findings of chronic otitis media(COM) with and without cholesteatoma, focusing on bone change. MATERIALS AND METHODS: Between 1997 and 1998, 82 patients(84 cases) underwent temporal bone CT and were shown to have COM, with or without cholesteatoma after mastoidectomy and tympanoplasty. There were 36cases of COM with cholesteatoma(26 patients, M:F=11:15; age range, 16 -61 [mean, 36.2] years), and 58 cases without cholesteatoma(56 patients, M:F=25:31, age range, 15 -61 [mean, 36.2]years). The findings of temporal bone CT were analyzed at the point of bony changes including erosion and medial displacement of ossicles(malleus, incus, and stapes), erosion or destruction of the scutum, tegmen, facial canal, and lateral semicircular canal, and ballooning of the tympanic cavity and mastoid antrum. In addition, the soft tissue changes seen on temporal bone CT were analyzed at the site of lateral bulging of soft tissue in Prussak's space, perforation of the pars flaccida, tympanic membrane retraction, and tympanosclerosis. We retrospectively compared the findings of temporal bone CT with the surgical findings, and to assess statistical significance, the Chi-square test was used. RESULTS: Bone erosion or destruction was seen in 36.2 % of COM cases without cholesteatoma, and in 96.2% of cases with cholesteatoma. Comparing COM with and without cholesteatoma, the erosion of ossicles includ-ing the malleus(81%, 24%), incus(88%, 14%), stapes(58%, 10%), scutum(88%, 10%), facial canal(8%, 0%), and lateral semicircular canal(8%, 0%), was more common in COM with cholesteatoma(p-value<0.05), with the exception of erosion of the tegmen(8%, 3%). Other bony changes including medial displacement of ossi-cles (27%, 3%), ballooning of tympanic cavity and mastoid antrum(96%, 16%), and the soft tissue changes including lateral bulging of soft tissue in Prussak's space(58%, 14%) and perforation of the pars flaccida(35% ,9%) were more common in COM with cholesteatoma (p-alue<0.05). Soft tissue in Prussak's space(58%, 72%), retraction of the tympanic membrane(1%, 9%), and tympanosclerosis(8%, 10%) were not however,important findings(p-value>0.05). CONCLUSION: Bone erosion or destruction was seen in COM without cholesteatoma, but expansile bone erosion or destruction with mass effect suggested COM with cholesteatoma. These findings of temporal bone CT in COM demonstrate the existence and extent of combined cholesteatoma, and are therefore valuable.
Cholesteatoma ; Diagnosis, Differential* ; Ear, Middle ; Humans ; Incus ; Mastoid ; Myringosclerosis ; Otitis Media* ; Otitis* ; Retrospective Studies ; Semicircular Canals ; Temporal Bone ; Tympanic Membrane ; Tympanoplasty

PURPOSE: In order to determine specific differences, we compared the temporal bone CT findings of chronic otitis media(COM) with and without cholesteatoma, focusing on bone change. MATERIALS AND METHODS: Between 1997 and 1998, 82 patients(84 cases) underwent temporal bone CT and were shown to have COM, with or without cholesteatoma after mastoidectomy and tympanoplasty. There were 36cases of COM with cholesteatoma(26 patients, M:F=11:15; age range, 16 -61 [mean, 36.2] years), and 58 cases without cholesteatoma(56 patients, M:F=25:31, age range, 15 -61 [mean, 36.2]years). The findings of temporal bone CT were analyzed at the point of bony changes including erosion and medial displacement of ossicles(malleus, incus, and stapes), erosion or destruction of the scutum, tegmen, facial canal, and lateral semicircular canal, and ballooning of the tympanic cavity and mastoid antrum. In addition, the soft tissue changes seen on temporal bone CT were analyzed at the site of lateral bulging of soft tissue in Prussak's space, perforation of the pars flaccida, tympanic membrane retraction, and tympanosclerosis. We retrospectively compared the findings of temporal bone CT with the surgical findings, and to assess statistical significance, the Chi-square test was used. RESULTS: Bone erosion or destruction was seen in 36.2 % of COM cases without cholesteatoma, and in 96.2% of cases with cholesteatoma. Comparing COM with and without cholesteatoma, the erosion of ossicles includ-ing the malleus(81%, 24%), incus(88%, 14%), stapes(58%, 10%), scutum(88%, 10%), facial canal(8%, 0%), and lateral semicircular canal(8%, 0%), was more common in COM with cholesteatoma(p-value<0.05), with the exception of erosion of the tegmen(8%, 3%). Other bony changes including medial displacement of ossi-cles (27%, 3%), ballooning of tympanic cavity and mastoid antrum(96%, 16%), and the soft tissue changes including lateral bulging of soft tissue in Prussak's space(58%, 14%) and perforation of the pars flaccida(35% ,9%) were more common in COM with cholesteatoma (p-alue<0.05). Soft tissue in Prussak's space(58%, 72%), retraction of the tympanic membrane(1%, 9%), and tympanosclerosis(8%, 10%) were not however,important findings(p-value>0.05). CONCLUSION: Bone erosion or destruction was seen in COM without cholesteatoma, but expansile bone erosion or destruction with mass effect suggested COM with cholesteatoma. These findings of temporal bone CT in COM demonstrate the existence and extent of combined cholesteatoma, and are therefore valuable.
Cholesteatoma ; Diagnosis, Differential* ; Ear, Middle ; Humans ; Incus ; Mastoid ; Myringosclerosis ; Otitis Media* ; Otitis* ; Retrospective Studies ; Semicircular Canals ; Temporal Bone ; Tympanic Membrane ; Tympanoplasty