Tympanosclerosis: causes, symptoms, diagnosis, treatment
Last reviewed: 20.11.2021
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Timpanosclerosis is characterized by cicatrical and degenerative manifestations in the middle ear, caused by the previous inflammatory-destructive process, culminating in scar tissue formation. As a result, various variants of scarring of the middle ear structures arise, consisting in replacement of the mucous membrane with connective tissue strata that hinder mobility in the joints of the auditory ossicles, causing obliteration of the windows of the ear maze, causing circulatory disturbances in the labyrinth wall and compression of the plexus plexus. These pathologic and anatomical factors cause, on the one hand, disturbances in sound production, on the other hand, trophic disorders of the tympanic plexus, its constant irritation and consequent secondary labyrinthopathy, manifested by constant ear noise, perceptive hearing loss and syndrome of vestibular dysfunction.
The causes of tympanosclerosis. The determining factors in the development of tympanosclerosis are acute or chronic catarrhal or purulent inflammation of the middle ear. The contributing factors are:
- periodic or permanent obstruction of the auditory tube;
- presence of chronic peritubar infection in the area of lymphadenoid tissue;
- individual propensity to transform connective tissue into cicatricial sclerotic;
- metabolic disorders leading to sclerosis, increased cholesterol and urea in the blood;
- allergy;
- frequent inflammatory diseases of the upper respiratory tract.
The clinical course of tympanosclerosis is characterized by a progressive decrease in hearing and a gradual increase in the symptoms of cochleo- and vestibulopathy. With a long course of the disease, signs of perceptive hearing loss develop, leading to a mixed form of it and a decrease in the reserve of the cochlea. With a bone-to-air rupture of less than 20 dB, surgical treatment of deafness is not very promising.
Diagnosis of tympanosclerosis is established on the basis of complaints, otoscopic picture, acoustic data and audiometry, X-ray examination.
Complaints: deafness, constant subjective low-frequency noise in the ear, periodic unexpressed dizziness. Acumetry indicates the presence of conductive or mixed (with prolonged process) hearing loss (conductive hearing loss): WR - from "the shell" to 3 m, negative Schwabach test, with Weber's test, lateralization of sound in the diseased ear. Ascending type of tonal audiogram with the availability of snail reserve, determined by the degree of involvement in the process of the sound-receiving apparatus. X-ray examination (Schueller and Highway projections, Guyillen transorbital, tomography, CT) indicate different types of destructive changes in the temporal bone, which indicate the presence of scar tissue in the tympanum and various types of destruction of its elements.
Treatment for tympanosclerosis may be non-operative (depending on the degree of development of tympanosclerosis) and surgical. The first involves the use of mainly physiotherapy methods and, first of all, restoration of the ventilation function of the auditory tube; the second - different types of tympanoplasty), as well as under appropriate anatomical conditions - stapedoplasty.
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