Tympanosclerosis refers to scarring of the eardrum due to infection, surgery, or injury. Many people with the condition do not experience any symptoms. Treatments may include hearing aids or surgery.
Tympanosclerosis is a post-inflammatory condition that affects the middle ear and tympanic membrane, also known as the eardrum. When tympanosclerosis affects only the eardrum, healthcare professionals call it myringosclerosis.
While scientists do not understand the exact cause of tympanosclerosis, they believe it may be due to chronic inflammation of the middle ear mucosa. Swelling of the tympanic membrane can cause calcium deposits to form, leading to tissue injury. This appears as chalky white lesions on the eardrum.
Tympanosclerosis is most common in people over 30 years old and can have a frequency rate of up to 62.9%, depending on the severity of the condition.
In this article, we will discuss tympanosclerosis, including the various symptoms, causes, and treatment options for the condition.
Symptoms
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Tympanosclerosis can be asymptomatic. This term means that many people with the condition do not experience any symptoms. For people with tympanosclerosis, symptoms may be mild, moderate, or severe and may include the following:
- an earache
- hearing loss
- swelling or inflammation in the ear
- chalky white appearance in the ear
If the symptoms are mild and do not affect a person’s hearing, they may not require treatment. However, tympanosclerosis can be severe when it affects sound transmission. This is typically the result of scarring and ossicular fixation — which occurs when the ear ossicles cannot move properly.
According to a 2022 study, tympanosclerosis may appear as an ovular, white, hard mass in the ear. Research from 2018 suggests that tympanosclerosis can cause the formation of a white crescent or semicircular plaques with varying consistencies.
Causes
Researchers do not know the exact cause of tympanosclerosis. However, they have identified some factors that may be responsible. These include:
- Ear infections: Ear infections, such as acute and chronic otitis media, adhesive otitis, or glue ear, can cause inflammation, leading to the development of tympanosclerosis.
- Trauma to the ear: Trauma to the ear due to irritation, an impact to the ear, or poking objects deep into the ear can damage the eardrum, leading to tympanosclerosis.
- Cholesteatomas: This is a skin growth that can develop in, and damage, the middle ear. They may harden and cause tympanosclerosis.
- Ear surgery: Surgery or invasive diagnostic procedures in the ear can rupture the eardrum. When this happens, tympanosclerosis can develop during the healing process.
Risk factors
The following risk factors can increase a person’s risk of tympanosclerosis:
- Atherosclerosis: According to a 2015 study, people with atherosclerosis may have a greater chance of tympanosclerosis than others.
- Tympanostomy tube placement: An older 2014 studyTrusted Source suggests that children with cleft palates, who had a ventilation tube inserted, may have a higher risk of developing tympanosclerosis. This may be due to scarring and thickening of the eardrum.
- Age: Tympanosclerosis is most common in people older than 30.
- Ear injury: People with ear injuries from accidents, contact sports, loud noises, and foreign objects are more likely to develop tympanosclerosis.
Diagnosis
To diagnose tympanosclerosis, a doctor, usually an otolaryngologist — which is an ear, nose, and throat (ENT) specialist — will take a person’s medical history and conduct a physical exam. They may also order additional testing, which can include:
- Audiometry exam: An audiometry exam tests a person’s hearing ability. The audiologist will play different sounds into a person’s ear via headphones at intervals to determine a person’s range of sound.
- Transtympanic endoscopy: In this procedure, the doctor explores the ear canal to look for any damage.
- Weber exam: This noninvasive procedure can help identify unilateral hearing loss. The doctor will strike a tuning fork and place it in the middle of a person’s head to determine in which ear the sound is louder.
- CT scan: According to a 2021 study, tympanosclerosismay appear on CT scans as linear or web-like forms of calcified masses in the middle ear cavity.
Treatment
An ENT specialist may recommend the following treatments for tympanosclerosis:
Surgery
Surgery is often an option for treating damage to the eardrum, such as tympanosclerosis. Depending on the severity, a doctor may perform a myringoplasty or tympanoplasty.
A myringoplasty involves temporarily covering the damage to encourage the healing process. In more severe instances, a doctor may recommend a tympanoplasty. This procedure involves surgically removing scar tissue from the eardrum and using a graft to replace the damaged tissue.
These procedures can offer significant benefits to people with hearing difficulties by:
- restoring optimal hearing
- improving the function of the eardrum
- preventing further damage
Hearing aids
If a person’s hearing does not improve after a surgical procedure, they should contact an ENT specialist. The specialist may recommend hearing aids to amplify sounds and make hearing effortless. They may also recommend the best hearing aids to meet a person’s needs.
Summary
Tympanosclerosis describes scarring of the eardrum following trauma, infection, or surgery. It may appear as a chalky white mass in the eardrum.
Symptoms can be mild or severe and may include ear pain, partial or total hearing loss, and inflammation. Typically, an ENT specialist will suggest surgery to repair damage to the eardrum. If surgery is unsuccessful, they may recommend surgery or hearing aids.
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