Tympanosclerosis

Description:

Tympanosclerosis [annate. (membrana) of tympani tympanic membrane + sclerosis; synonym: a pseudootosclerosis, an otosclerosis] - the disease which is characterized by growth of connecting fabric in a mucous membrane of a middle ear with the subsequent its hyalinosis, calcification and ossification that leads to defeat of the sound carrying out device of an ear and relative deafness.

The tympanosclerosis concerns to group of complete forms of fibroziruyushchy average otitises.

Tympanosclerosis reasons:

Tympanosclerosis - an outcome of a catarrh of a mucous membrane of a drum cavity (in serous option). This pathological process is morphological expression of focal reaction of a mukoperiost at not purulent forms of an inflammation. The local, sharply limited from surrounding fabric white plaques are located in the depth of a mucous membrane, is more often in the field of a threshold window, including a stirrup, an upper part of a promontorium, is more rare in the thickness of a tympanic membrane, in a cave.

Pathogeny:

Assume that emergence of the changes in a drum cavity characteristic of a tympanosclerosis can be connected with an allergic background on which the inflammation of a middle ear proceeds. Otokhirurgami is saved up the considerable material characterizing a tympanosclerosis as a special type of effects of purulent average otitis. The mucous membrane of a middle ear becomes dense, compact, vibration ability of a tympanic membrane and ring linking of a stirrup is broken, in a drum cavity the commissures breaking mobility of a chain of acoustical stones and a tympanic membrane develop. On walls of a drum cavity stratifications are formed. At a limited form they occupy certain sites of a tympanic membrane and walls of a drum cavity, are located in a threshold window dimple, in an entrance to a cave, on the surface of the cape. At a common form practically all drum cavity is executed by waxy dense fabric in which the chain of acoustical stones is immured. In some cases there is a destruction of a wall of the channel of a facial nerve, a long leg of an anvil, stirrup. At microscopic examination fibrosis and a hyalinosis, lipoid infiltration of the struck fabrics, changes of collagenic fibers, adjournment of salts of calcium come to light.

Tympanosclerosis symptoms:

The main symptom of a tympanosclerosis is resistant relative deafness in the absence of suppuration from an ear. The Otoskopichesky picture is usually characterized by existence in a tympanic membrane of an extensive perforative opening with reinforced edges through which sometimes it is possible to see stratifications, typical for a tympanosclerosis, in some cases there is an extensive atrophic hem. Most authentically manifestations of a tympanosclerosis can be found by means of an operative microscope.

Tone threshold audiometriya - the mixed relative deafness with dominance of a conductive component as high thresholds of hearing at bone sound carrying out are observed seldom. Otoskopiya - cicatricial changes of a tympanic membrane. Unlike petrifikat timpanosklerotichesky plaques are always intimately connected with the hammer handle.

Treatment of a tympanosclerosis:

Assessment of a condition of a nose, throat. Conservatively - blowing off of an acoustical pipe, massage of a tympanic membrane. Physical therapy - UVCh, ultrasonic massage of tubarny rollers, an electrophoresis and endauralny фонофорез lidaza. Parenterally enter a vitreous, an aloe, cocarboxylase. Inside - antihistaminic drugs.

Surgical treatment of a tympanosclerosis - formation of an epithelial vystilka of a drum cavity and improvement of tubarny function. Efficiency of surgical treatment low.

The type of intervention depends on the nature of process, its prevalence, extent of destruction of acoustical stones and a tympanic membrane. During operation delete stratifications, as much as possible sparing at the same time a chain of acoustical stones and a mucous membrane of a drum cavity.

After operation mobility of acoustical stones is often recovered, and process usually does not recur. At a widespread tympanosclerosis owing to considerable destructive changes on average an ear and emergence of granulations on site remote timpanosklerotichesky stratifications the forecast less favorable.