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Chronic Otitis Media
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Tympanosclerosis describes the deposition of calcium or bone at sites of previous middle ear inflammation. Usually it affects only the tympanic membrane (myringosclerosis) and is of no consequence. Rarely it may be found to affect the ossicles, often in an ear undergoing exploration for conductive hearing loss, causing fixation of the ossicular heads (treated with partial ossiculoplasty) or around the stapes footplate (usually causing surgery to be abandoned).
Ear, nose and throat disorders
Published in Rachel U Sidwell, Mike A Thomson, Concise Paediatrics, 2020
Rachel U Sidwell, Mike A Thomson
Perforation of the central tympanic membrane is a ‘safe’ perforation, and may be active, i.e. discharging, or inactive when the only sign is the perforation. There is conductive deafness and in Long-standing cases a coexistent sensory Loss. This can heal spontaneously Leaving tympanosclerosis.
Chronic Otitis Media
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
George G. Browning, Justin Weir, Gerard Kelly, Iain R.C. Swan
Tympanosclerosis is found in the middle ear in around 25% of ears at surgery. In some cases, the mobility of the ossicular chain is reduced by tympanosclerosis in the attic or in the oval window. If the ossicular chain is intact and only the incus and head of malleus are fixed, this can be corrected by removing the incus and head of malleus and reconstructing the ossicular chain between handle of malleus or tympanic membrane and stapes. Alternatively, the outer attic wall can be removed and the malleus and incus mobilized. This is often effective in the short term, but there is a tendency for refixation of the ossicles by fibrous tissue or bone.
Transcanal endoscopic management of isolated congenital middle ear malformations
Published in Acta Oto-Laryngologica, 2023
Licai Shi, Shuainan Chen, Rujie Li, Yideng Huang
Undoubtedly, HRCT plays a vital role in preoperative evaluation. Because it can not only help operators predict some ossicular chain malformations in advance, but also detect inner ear malformations, congenital middle ear cholesteatoma and other lesions. Our study found that most cases of CMEMs, such as loss of superstructure of stapes, malleus fusion deformity, long process dysplasia of incus and oval window atresia, can be easily found on preoperative HRCT. A retrospective study of 132 cases (145 ears) of CMEMs by Zhang et al. [10] showed that 62.1% cases could be identified as isolated CMEMs and at least one as middle ear anomaly by preoperative HRCT, which was similar to our preoperative HRCT prediction of isolated CMEMs. However, HRCT is still difficult to detect some minor malformations (such as isolated stapes footplate fixation and discontinuity of the incudostapedial joint), so exploratory tympanotomy under ear endoscope is the key to determining the final diagnosis. In addition, there was no significant difference in preoperative and postoperative hearing evaluation between the stapes fixation group and the stapes mobile group. However, some reported that difference between the two groups of patients with tympanosclerosis for hearing improvement was statistically significant [11].
Clinical features of 22q11.2 deletion syndrome related to hearing and communication
Published in Acta Oto-Laryngologica, 2020
Noriomi Suzuki, Sho Kanzaki, Takafumi Suzuki, Kaoru Ogawa, Hiroyuki Yamagishi
The frequency of moderate hearing loss is high [9,11,12] in patients with middle ear malformations. For example, 80% of patients with middle ear malformations in our study had moderate hearing impairment. However, these malformations were not detected on temporal bone CT scans in two ears with moderate hearing impairment. We confirmed ossicular fixation during surgery in one ear and suspected ossicular fixation in the other ear owing to persistent conductive hearing loss after tympanostomy tube placement for otitis media with effusion. Previous studies reported that tympanosclerosis was suspected after CT scans in two cases only: one was reported by Verheij et al. [9] and the other by Jiramongkolchai et al. [11]. However, these authors failed to report whether sclerosis was confirmed during surgery. In the present study, we observed that middle ear malformations, including ossicular fixation, might exist in patients with moderate hearing loss in whom morphological anomalies and inflammation appeared to be absent on CT.
Long-term outcomes in children with and without cleft palate treated with tympanostomy for otitis media with effusion before the age of 2 years
Published in Acta Oto-Laryngologica, 2020
Maki Inoue, Mariko Hirama, Shinji Kobayashi, Noboru Ogahara, Masahiro Takahashi, Nobuhiko Oridate
This study had some limitations. First, the number of children in the study group and in the control group was relatively small, because almost half of the children were followed-up for less than 7 years, as they had OME resolution. Second, in this study it was difficult to precisely evaluate the degree of tympanosclerosis and its extension to the middle ear, particularly in healed ears. Third, it was difficult to define the actual time needed to achieve an aerated middle ear after the intervention, although this information would provide a better comparison between the two groups. Instead, this study showed the otological and audiological outcomes at a maximum age of 7 years and suggested that these outcomes were similar in the two groups.