Reconstructive Techniques for Tympanosclerosis

Abstract

Tympanosclerosis is found in more than 30% of patients with chronic ear disease. Clinically significant tympanosclerosis is defined as that affecting the surgical procedure by requiring removal to effect a hearing improvement. This type is seen in less than half of all patients with tympanosclerosis. The incidence and patterns of involvement are documented for 352 of the author's surgical patients subdivided into two groups: one operated on in the early 1960s and another observed more than 15 years later. The surgical techniques employed for hearing restoration are described, as are the hearing results obtained. The findings would indicate that tympanosclerosis is amenable to surgical correction, with a success rate approximately that of nontympanosclerotic ears. The special techniques needed to avoid complications when the disease invades the oval window are emphasized.

The effect of stapes mobility on hearing outcome and which procedure to choose in fixed stapes in children tympanosclerosis

“…Involvement of multiple sites were seen in 35.6% of temporal bones [7]. Ossicular chain fixation frequently occurs in the stapes area [1,14]. In this report the most common finding of tympanosclerosis in children is the involvement of multiple sites, especially at the region of epitympanum and the middle ear.…”

“…Hearing aid use may be a preferred alternative for some otologists and patients; but they are very often refused by young patients. Whereas some surgeons consider TS a possible contraindication to ossiculoplasty in cases of stapes fixation [1], others believe that significant benefit can be achieved with surgery [14,15]. When surgery is the choice of treatment, you can perform one-or two-staged surgery.…”

“…Mobilization was generally considered as the first option for several otologists because it has the advantage of completing the operation in one stage [3,14,15] and has the merit of preserving an intact chain. Important disadvantages are the occurrence of a postoperative sensorineural hearing loss [17,20] and tendency for postoperative scarring and refixation by fibrous tissue or bone [24].…”

Prognostic significance of tympanosclerotic plaques localization and their morphological and histological characteristics for the outcome of surgical treatment

“…Giddings and House 9 has the same opinion giving the priority to stapedectomy in managing tympanosclerosis of the stapes. There is not the small number of authors who accept both attitudes, documenting no difference between mobilization and stapedectomy or stapedoplasty 10 speaking discrimination and hearing condition in stapedectomy. Tuefert and De La Cruz 3 make a difference between mobilization and stapedectomy.…”

Tympanoplasty: Factors Influencing Surgical Outcome

“…Some authors have not considered this a significant factor. 17,19 In this study, plaques were removed if they involved the perforation margins and were mobile. Seventy-one patients had tympanosclerosis and 112 patients were free.…”