Abstract
Tympanosclerosis is a common clinico-pathological entity of the middle ear cleft. Its pathogenesis is well explained in the light of the crucial role of free oxygen radicals through the cascade of events during a longstanding inflammatory process. Its particular histopathology along with the electron microscopy inputs are detailed. The sites of predilection of tympanosclerosis in the middle ear cleft are described.
In half of cases, myringosclerosis is the only manifestation that is mostly silent. However, intratympanic tympanosclerosis could cause significant conductive hearing loss in 40% of cases.
Clinico-radiologic correlations have been established over a period of several years of follow up, aided by a series of typical tympanosclerotic aspects on CT imaging yet rarely reported in the literature.
The concepts of surgical treatment of tympanosclerosis, either the indications or the special procedures, are described; this according to the involvement of incudo-malleolar complex, the stapes complex, or possibly both in the same ear. The management of bilateral tympanosclerosis is also discussed. According to the clinic-radiological staging of tympanosclerosis, an algorithm of surgical strategies is proposed. Also conservative options of treatment for advanced forms of the disease are reviewed. Finally several cases of tympanosclerosis associated to other pathologies in the same ear are reported, aiming to be aware about the diagnostic dilemma in these associations.
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Mansour, S., Magnan, J., Nicolas, K., Haidar, H. (2018). Tympanosclerosis. In: Middle Ear Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-72962-6_5
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