1.Advances in research on treatment of tympanosclerosis.
Xin WANG ; Lingyun MEI ; Lu JIANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):86-90
Tympanosclerosis is the hyaline degeneration and calcium deposition of the lamina propria of tympanic membrane and the submucosa of middle ear under long-term chronic inflammatory stimulation. At present, treatment primarily involves the surgical removal of sclerotic foci and reconstruction of auditory ossicular chain. However, excision of sclerotic lesions near critical structures like the facial nerve canal and vestibular window may result in complications like facial paralysis, vertigo, and sensorineural hearing loss. Developing safer and more effective treatments for tympanosclerosis has become an international research focus. Recent years have seen novel explorations in the treatment of tympanosclerosis. Therefore, this article reviews the latest advancements in research on the treatment of tympanosclerosis.
Humans
;
Tympanoplasty
;
Ear, Middle
;
Ear Ossicles/surgery*
;
Tympanic Membrane/surgery*
;
Tympanosclerosis
2.Analysis of medium and long term efficacy of ossicle chain bypass technique in treatment of tympanosclerosis.
Ningyu FENG ; Ying ZHANG ; Pei DONG ; Xueliang SHEN ; Ming LIU ; Yaxin WANG ; Ruixia MA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(10):815-818
Objective:For tympanosclerosis patients with ossicular chain fixation, we use ossicular chain bypass technique and evaluate its long-term effects. Methods:From June 2017 to June 2019, 147 patients with tympanosclerosis who underwent middle ear surgery with otoscopy in Yinchuan First People's Hospital were reviewed. The subjects were divided into three groups according to the implemented operation plan, 51 cases in the ossicular chain mobilization group(OCM), 56 cases in the ossicular chain bypass reconstruction group(OCB), and 40 cases in the malleus-incus complex resection reconstruction group(MICR). Through a three-year follow-up, the medium and long-term effects of different operation plans were compared and analyzed. Results:There was no significant difference among the three groups in the incidence of tympanic membrane perforation, delayed facial nerve palsy, and the dispatch and displacement of PORP. The incidence of tympanic membrane retraction pocket or cholesteatoma after operation in OCB group(0) was significantly lower than that in OCM group(11.76%) and MICR group(7.5%)(P<0.05). At 12 months after operation, ΔABG of OCB group and MICR group were better than that in the OCM group(P<0.05). At 36 months after operation, ΔABG of OCB group was better than that in the OCM group(P<0.05), and there was no significant difference between OCB group and MICR group. The audiological performance of patients with epitympanic sclerosis(ETS) at 12, 24 and 36 months after operation was better than that of patients with posterior tympanosclerosis(PTS) and total tympanosclerosis(TTS)(P<0.05). Conclusion:Compared with patients undergoing ossicular chain mobilization and malleus-incus complex resection for ossicular chain reconstruction, patients with tympanosclerosis undergoing bypass technique have better and stable hearing prognosis in medium and long term. This technique can effectively prevent the formation of retracted pocket and cholesteatoma in patients with tympanosclerosis after operation.
Humans
;
Tympanosclerosis
;
Ear Ossicles/surgery*
;
Ear, Middle
;
Malleus/surgery*
;
Cholesteatoma
;
Retrospective Studies
;
Ossicular Prosthesis
;
Treatment Outcome
3.Neuroglial Choristoma of the Middle Ear with Massive Tympanosclerosis: A Case Report and Literature Review.
Hyun Joon SHIM ; Yong Kyung KANG ; Yong Hwi AN ; Young Ok HONG
Journal of Audiology & Otology 2016;20(3):179-182
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
4.Do All Antioxidant Supplements Have the Same Potential Effect on Preventing Myringosclerosis?.
Seden AKDAGLI ; Arzu TUZUNER ; Sule DEMIRCI ; Hatice KARADAS ; Kamil Gokce TULACI ; Mehmet DOGAN ; Refik CAYLAN
Clinical and Experimental Otorhinolaryngology 2015;8(1):1-6
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
5.Clinical analysis of tympanosclerosis: characteristics and treatment.
Shaoxing ZHANG ; Furong MA ; Tao PAN ; Jia KE ; Ke ZHANG ; Yu SONG ; Liwei JIANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(14):1238-1242
OBJECTIVE:
To explore the clinical characteristics, diagnosis and surgical management of tympanosclerosis.
METHOD:
The data of 73 patients who underwent surgery for tympanosclerosis were retrospectively analyzed with respects to the clinical characteristics, diagnosis and management.
RESULT:
Seventy-three patients with tympanosclerosis (involving 73 ears) , including 17 patients with sclerosis of tympanic membrane (type I), 23 patients with fixed Malleus-incus complex (type II), 8 (type III) with fixed stapes, and 25 (type IV) with extensive typannosclerosis. Sclerosis was seen most frequently in the malleus, incus and attic, followed by the tympanic membrane, incudomalleolar joint and other regions. Audiometry was performed for all the patients 1 weeks before and 1 year( the least) after operation, which were (51.70 ± 14.93)dB HL and (36.24 ± 11.58) dB HL respectively, with success rate 83% (61/73).
CONCLUSION
Most of the patients suffer from conductive hearing loss. Teatment of the sclerosis around stapes is a key point. Acording to the sites of lesion and hearing level, hearing structures should be reconstructed by the rules of tympanoplasty and stapes surgery.
Audiometry
;
Ear, Middle
;
pathology
;
Hearing
;
Hearing Loss, Conductive
;
complications
;
Humans
;
Incus
;
pathology
;
Malleus
;
pathology
;
Myringosclerosis
;
diagnosis
;
surgery
;
Retrospective Studies
;
Stapes
;
pathology
;
Stapes Surgery
;
Tympanic Membrane
;
pathology
;
Tympanoplasty
6.Tympanosclerosis etiology and treatment.
Xueling JIN ; Jian ZHANG ; Wugen LUO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(22):1811-1814
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
7.Destrution of ossicular chain and it's impact on hearing of patients with tympanosclerosis.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2013;27(1):27-30
OBJECTIVE:
To study the destruction ossicular chain's impact on hearing of patients with tympanosclerosis.
METHOD:
A retrospective review was conducted in 115 patients with tympanosclerosis, all patients were divided into 3 groups, including normal ossicular chain structure (A group), fixed ossicular chain(B group), and interrupted ossicular chain (C group). The audiological feature of the patients were compared between the 3 group.
RESULT:
Difference were significant for PTA, 0.5, 1.0, 2.0, 4.0 kHz air conduction threshold between 3 group (P < 0.01). Difference were significant for air bone gap (ABG) between A, B groups and C group (P < 0.01), there was no difference for ABG between A and B group (P > 0.01). Difference were significant for air conduction threshold between 0.5, 1.0 kHz and 2, 4 kHz in A, B groups (P < 0.01), but there was no significant for same data in C group (P > 0.01). Difference were significant for average bone conduction, 1, 2, 4 kHz bone-conduction threshold between A group and B, C group (P < 0.01). The rate of Carhart notch was low and had no difference between 3 group (P > 0.01).
CONCLUSION
The ossicular chain was fixed in patients who's PTA > or = (54.31 +/-13.19) dB HL and was interrupted who's PTA > or = (63.90 +/- 20.29) dB HL or ABG > or = (33.23 +/- 8.49) dB HL. The rising shaped curve in air-conduction audiograph may indicate the ossicular chain was fixed,and the smooth shape curve may indicate the ossicular chain was interrupted.
Adolescent
;
Adult
;
Aged
;
Audiometry, Pure-Tone
;
Bone Conduction
;
Child
;
Ear Ossicles
;
pathology
;
Female
;
Hearing
;
Humans
;
Male
;
Middle Aged
;
Myringosclerosis
;
pathology
;
physiopathology
;
Retrospective Studies
;
Young Adult
8.The impact of malleus processing in ossicular chain reconstruction on the therapeutic effect in patients with tympanosclerosis.
Fan SHU ; Menghe GUO ; Nanping XIE ; Hongzheng ZHANG ; Liangcai WAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2013;27(10):455-457
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
9.Effectiveness of Stapes Mobilization in Tympanosclerotic Stapes Fixation.
Hun Yi PARK ; Hyung Jin JUN ; Yun Hoon CHOUNG ; Keehyun PARK
Korean Journal of Audiology 2011;15(1):19-24
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
10.Grommet Cholesteatoma.
Hoon Young WOO ; Young Sam YOO ; Chan CHOI ; Jung Hyeob SOHN
Korean Journal of Otolaryngology - Head and Neck Surgery 2007;50(6):545-547
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

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