tympanosclerosis

Tympanosclerosis is a condition characterized by calcified or hyalinized deposits in the tympanic membrane and, in some cases, the middle ear structures such as the ossicles. It is often described in two related forms: myringosclerosis, where plaques are confined to the tympanic membrane, and tympanosclerosis when the middle ear and ossicular chain are involved.

Most cases arise after chronic middle ear inflammation, including otitis media with effusion, recurrent ear infections, or prior ear surgery and tympanostomy tube placement. The resulting scarring can appear as chalk-like white patches on otoscopic examination. When the condition involves the tympanic membrane alone, it is usually of limited clinical consequence; involvement of the ossicles can cause conductive hearing loss.

Diagnosis is typically clinical, based on history and a visible tympanic membrane patch. Audiometry assesses any associated conductive hearing loss, while tympanometry may show reduced tympanic membrane mobility. Imaging, such as CT, is not routinely required but can be helpful in preoperative planning if ossicular involvement or extensive disease is suspected.

Management is generally conservative, with observation for asymptomatic individuals. Surgical intervention may be considered for significant conductive hearing loss or functional impairment, including tympanoplasty to repair the tympanic membrane and, if needed, ossicular reconstruction. The condition is not cancerous, and prognosis is typically good for stability; progression is uncommon, and many patients remain asymptomatic. Regular monitoring is advised if symptoms or hearing changes develop.