Dr. T. Balasubramanian M.S. D.L.O.
is deposition of acellular hyaline and calcium
deposits within the submucous layer of the tympanic membrane /
submucous membrane of the middle ear cavity. In a majority of patients
these plaques are so insignificant that they cause very little
impairment in the hearing ability of the patient. These plaques could
be likened to healed scar tissue.
present over the tympanic membrane these plaques appear like a whitish
cresentic shaped plaques.
Could be caused by resolved otitis media.
Chronic otitis media with effusion
After recurrent bouts of acute otitis media (middle ear
After grommet insertion
Eustachean tube obstruction
Autoimmune process occurring within tympanic membrane
Fig showing healed central perforation with tympanosclerotic plaque
There is hyalinisation of the subepithelial
connective tissue of the tympanic membrane and middle ear cavity.
Calcifiation is commonly present in these lesions. Osteoneogenesis can
also occur within these lesions.
Fig showing histology of tympanosclerosis
Plaques occurring in the tympanic membrane is
limited to lamina propria. Deposition of bone due to osteoneogenesis in
the attic region may cause fixation of malleus and incus leading on to
It has been postulated that after an episode of
otitis media with effusion / or acute otitis media the collagen
undergoes degeneration and subsequent dystrophic calcification and
formation of tympanosclerosis.
Most of the patients with tympanoslerosis are
symptom free and the finding is purely accidental. If these patients
have significant conductive deafness then surgical removal of the
plaques from the tympanic membrane and fashioning a neo tympanic
membrane using temporalis fascia graft can be attempted. If these
plaques involve the attic area and cause ossicular fixation leading on
to conductive deafness, ossiculoplasty can be attempted.
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