Details
Category: Volume 08 Issue 01 January 2020
Hits: 1126

Title: A Study of Type – I Tympanoplasty in Tympanosclerosis of Tympanic Membrane with Central Perforation

Authors: Dr Niharika Muddada, Dr S. Surya Prakasa Rao, Dr T.V.S.S.N. Leela Prasad, Dr K.V. Madhavi Latha

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.36

Abstract

Background: Tympanosclerosis is a common sequela of chronic otitis media found in all age groups, and it is the irreversible terminal stage of a pathological process based on the inflammation of middle ear mucosa, which was not regressed to restitution and integrum and which does not continue as an inflammatory process.

However, in spite of its inertness, it is a major clinicopathological thing as it may result in a rigidity of the sound conducting mechanism of the ear.

Aim: In the present study, the aim is to study Type – I tympanoplasty in tympanosclerosis patients in regards to their clinical presentation and graft uptake and hearing improvement by different techniques.

  1. Underlay graft by removing only tympanosclerotic plaques leaving remnants of the tympanic membrane
  2. Underlay graft by removing both tympanosclerotic plaques and remnants by making into a subtotal central perforation.
  3. Underlay graft without removing tympanosclerotic plaques.

Materials and Methods: The material is chiefly from those patients who attended the outpatient department of government ENT hospital, Visakhapatnam with a history of decreased hearing, ear discharge.60 cases of tympanosclerosis were selected and studied for a period of 18 months, i.e., from August 2017 to January 2019.

Results: This study showed that slight female preponderance with female: male 1.30 : 1 ; Out of 60 patients in the study group most common age group being 25-40 years. Results of the surgical procedure were good, with graft taken up well in all the cases of Group –A whereas in one case residual central perforation noted in Group – B and one case in Group – C with no significant difference seen in the hearing improvement with the presence of the tympanosclerotic plaque unless it is present at a site with some fixity of the sound conducting mechanism.

Conclusion: Tympanosclerosis is associated with a predominantly conductive type of hearing loss. Hearing loss can be alleviated to a greater extent in a majority of patients by an appropriate surgery.

Keywords: Tympanosclerosis, Tympanosclerotic plaques, Tympanoplasty.

References

  1. House WF, Sheehy JL. Tympanosclerosis. Archives of Otolaryngology 1960; 72: 38-43.
  2. Von Tröltsch AF. Lehrbuch der Ohrenheilkunde. F.G.M. Vogel. Leipzig; 1873.
  3. Zöllner F & Beck C. Die Paukensclerose. Laryng Rhinol Otol 1955; 34: 137-55.
  4. Zöllner F.Tympanosclerosis. Arch Otolaryng (Chic.)1963; 78: 53844.
  5. Brockman SJ. Problems encountered in tympanoplastic surgery. Laryngoscope 1961; 71: 859-66.
  6. Joseph RB, Gordon J. Tympanosclerosis. Arch Otolaryngol 1963; 77: 186-90.
  7. Igarashi M, Konishi S, Alford BR, Guilford FR. The pathology of tympanosclerosis. Laryngoscope 1970; 80: 233-43.
  8. Schuknecht HF. Pathology of ear. Cambridge, M.A: Harvard University Press; 1974.
  9. Bhaya, MH, Schachern, PA Morizono T, Paparella MM. Pathogenesis of Otolaryngol -Head Neck Surg 1993;109:413-20.
  10. Hatem S. Badran ,Hazem M. Abdel Tawab, Basim M. Wahba, Khairy M. Abulnasr Myringosclerosis with Chronic Safe Suppurative Otitis Media: Hearing Outcome after Surgical Management According to Myringosclerotic Patch Site and Inclusion in the Surgery - Int Adv Otol 2014; 10(3): 260-3 DOI: 10.5152/iao.2014.467.
  1. Pal Indranil, Sengupta A (2005) Clinicopathological and audiological study of tympanosclerosis Indian Journal of Otolaryngology 57: 235-239.
  2. Ameya Asarkar and Shishir Gosavi Tympanosclerosis – a Beginner’s Worry: a Case Series and Review of Literature Otolaryngology 2013, Vol 3(2): 133 DOI: 10.4172/2161-119X.1000133.
  3. Gibb Tympanosclerosis. Acta Otolrhinol Belgiga 1971;25:956.
  4. Saad Asiria, Alaa Hashama, Fatma A Anazy, Siraj Zakzouka, and Adel Banjar (1999) Tympanosclerosis: Review of literature and incidence among patients with a middle ear infection. Journal of Laryngology and Otology 113: 1076-1080.
  5. Jaishinghani VJ, Hunter LL, Li Y, Margolis RH. Quantitative analysis of tympanic membrane disease using video-otoscopy. Laryngoscope 2000;110:1726-30.
  6. Ferlito Pathologia del Otomastoidite Purulenta Cronica. AttiDell’ Accademia Nazionale dei Lince, S VIII, 1974;12:53.
  7. Kamal Surgery of tympanosclerosis. J Laryngol Otol 1997;111:917- 23.

Corresponding Author

Dr S. Surya Prakasa Rao

Professor of ENT, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India