Myringosclerosis, Tympanosclerosis, and Ear Health

Myringosclerosis and tympanosclerosis are similar conditions that affect the middle ear, causing the tympanic membrane (eardrum) to appear bright white. Mild and often reversible hearing loss can occur with either, though it's more common and damaging with tympanosclerosis.

The pathology of myringosclerosis and tympanosclerosis is not always well understood. With tympanosclerosis, deposits formed by calcified collagen appear on the eardrum but also the middle ear structures. Eardrum deposits are a feature of myringosclerosis, but they also appear to go through other molecular changes. It is often seen in children.

This article explains the symptoms, causes, and compares the treatment of both myringosclerosis and tympanosclerosis. It will help you to know risk factors that may lead to these ear problems.

Symptoms of Myringosclerosis and Tympanosclerosis

Myringosclerosis usually does not cause any symptoms, but it can sometimes be associated with a very mild conductive hearing loss. Hearing loss is more common with tympanosclerosis.

Depending on the situation, hearing loss caused by myringosclerosis or tympanosclerosis can often be reversed entirely or significantly improved with treatment.

What Causes Myringosclerosis and Tympanosclerosis?

The eardrum is normally thin and translucent. With these conditions, it may thicken, harden, and lose its flexibility. Chronic inflammation in the middle ear may cause these changes.

Conditions that may contribute to the development of myringosclerosis and tympanosclerosis include:

• Chronic fluid in the ear, including otitis media with effusion (OME), serous otitis media (SOM), and secretory otitis media
• Untreated or chronic middle ear infections
• The surgical placement of ventilation tubes (also called myringotomy tubes or ear grommets)
• In rare cases, trauma such as severe or repeated ruptured eardrum
• Genetic predisposition
• Antioxidant behavior, with oxidative stress and inflammation
• Autoimmune disease

A 2020 study of 582 people treated with a ventilation tube procedure found 29% developed myringosclerosis. The results were consistent with other research that identifies roughly a third of people developing the condition after ear tube placement.

Diagnosing Myringosclerosis and Tympanosclerosis

An otolaryngologist, a healthcare provider specializing in diagnosing and treating ear, nose, and throat disorders, evaluates these conditions. Methods include:

• Exam: A healthcare provider asks about fluid in the ears, infections, or ear surgeries. Next, they will most likely use an otoscope inserted into the ear to view the ear canal and eardrum.
• Hearing tests: If your healthcare provider notices white patches or eardrum thickening, they may use a hearing test to confirm a diagnosis. Conductive hearing loss may indicate tympanosclerosis. A tympanometry test delivers sound waves into the middle ear. When presented on a graph, a flat wave can mean a rigid eardrum.

How Are Tympanosclerosis and Myringosclerosis Treated?

Myringosclerosis is usually asymptomatic and doesn't typically require treatment. However, there's some evidence that symptoms can be avoided with the type of surgical approach (radiofrequency vs. incision). More study is need, but other treatments to prevent myringosclerosis may include:

• Antioxidants to reduce free radicals
• Topical vitamin E
• Ciprofloxacin, an antibiotic

The treatment for tympanosclerosis is surgery to repair the eardrum and any other middle ear structures involved. A surgeon will remove the hardened (sclerotic) portions of the eardrum during surgery. They may also have to repair the middle ear bones (ossicular chain).

A complication that sometimes occurs with tympanosclerosis is when the stapes (the third bone in the middle ear) become fixed. When this happens, the stapes can't move and therefore can't transmit sound. In these circumstances, a surgeon will perform a stapedectomy or stapedotomy.

Endoscopic surgery also is possible. If the hearing loss does not entirely resolve following the surgery, a device such as a hearing aid may be helpful.

Summary

Myringosclerosis and tympanosclerosis are conditions that occur with calcification on the eardrum or, as occurs with the latter, a spread into the middle ear. Myringosclerosis doesn't always cause symptoms, but tympanosclerosis may result in hearing loss. Myringosclerosis is common in children and often associated with ear tube treatment.

Researchers aren't clear on the causes, though myringosclerosis is common in children and often associated with ear tube treatment. Treatment isn't always necessary for myringosclerosis. However, surgery and hearing aids might help tympanosclerosis.

It's important to see a healthcare provider for a correct diagnosis and early treatment. It's possible that permanent hearing loss or serious complications can occur without treatment.