Tympanosclerosis
Introduction
Introduction to tympanosclerosis Tympanic sclerosis, also known as tympanic glass degeneration, is a plaque-like collagenous tissue deposited under the mucosal epithelium of the tympanic cavity. It occurs mostly in the tympanic membrane mucosa and ossicular bone. The tympanic membrane is still called calcified plaque, which makes the tympanic membrane become milky skin. The sample material covers the bones, the oval window and the round window, and adheres to the bones. It seems to be coated with a layer of capsule. The person involved in the upper tympanic cavity is heavier, and the lower tympanic cavity is lighter. Hammer bone, anvil bone, Bone and tendon are the most susceptible, so many people are deaf. This disease was discovered by Cassebohm in the 18th century, but it did not attract attention. It was not until the modern (1955) a large number of microsurgical operations. The main symptom of the disease is gray-white plaques of different sizes on the surface of the tympanic membrane. Sometimes, through the large perforations, there are gray-yellow hard plaques on the drum ring, the surface of the drumstick, the shank of the hammer and the tibia. Sometimes the tympanic membrane is normal, but the patient Progressive deafness. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: hearing impairment
Cause
The cause of tympanosclerosis
Cause (75%):
Acute necrotizing otitis media:
Common in acute necrotizing otitis media, due to a large number of destruction of mucociliary and gland, exudate can not be discharged, and later mechanicalized glass denaturation, and form hardened plaque.
Chronic otitis media:
Caused by chronic otitis media, accounting for about 10%, more common in young and middle-aged, more women, the reason for the induction of collagen tissue proliferation, may be related to the serious destruction of cilia and glandular secretion of otitis media, the diseased tissue is the mesodermal connective tissue, May cause bone absorption, tissue structure and keloid similar, but the cause is completely different, neither allergic, nor specific bacterial and viral infections, plaque tissue under the microscope is divided into two types:
1 soft cheese-like shell and bone adhesion is not heavy, like onion skin can be peeled off.
2 solid, white lumps, tightly adhered to the bone, difficult to remove, and soon after removal, the plaque is glass-like collagen tissue, no cells and blood vessels, covered with a very thin squamous epithelium, ossicle necrosis Shape, often caused by ossicular chain interruption and fixation.
Harris (1961) divided the tympanic hardening into two categories:
1 superficial sclerosis mucositis: does not damage the deep layer of the mucosa and the bone coat.
2 deep osteoclast mucositis: can destroy deep bone, some people oppose this argument, think that tympanosclerosis is an inactive disease, without destroying bone function, the bone destruction may be surrounded by hard spots Due to blood necrosis, ultrastructural electron microscopy showed collagen fibrosis, degeneration and calcium deposition in the extracellular space. Gibb (1976) reported plaque biochemical analysis, the main component was calcium phosphate.
Prevention
Tympanic sclerosis prevention
1. Prevent otitis media and actively treat ear inflammation.
2, a balanced diet and lifestyle. Reduce the use of tobacco, alcohol and spicy irritating foods, avoiding the possibility of catching a cold, can maintain the health of the nose, throat and eustachian tube, thus preventing the deterioration of otitis media.
3, otitis media patients should maintain the tranquility of the surrounding environment, not excessive exercise, can not play the flute and balloons, keep mouth hygiene at any time, try to breathe with the nose, sleep when lying on the side of the ear.
Complication
Tympanic sclerosis complications Complications, hearing impairment
Large perforations in the tympanic membrane may occur, directly affecting the tympanic membrane and ossicular activity, leading to hearing impairment.
Symptom
Tympanic sclerosis symptoms common symptoms hearing loss deafness otosclerosis tympanic scarring
The surface of the tympanic membrane is gray-white plaques of different sizes. Sometimes, through the large perforations, there are gray-yellow hard plaques on the drum ring, the surface of the drumstick, the hammer stem and the tibia. Sometimes the tympanic membrane is normal, but the patient is progressive deafness.
Examine
Tympanic sclerosis examination
According to medical history and otoscopy, pure tone audiometry and acoustic impedance test, CT scan of the tibia, the diagnosis is not difficult.
Pure tone audiometry is a standardized subjective behavioral response audiometry that tests hearing sensitivity. It includes air conduction hearing threshold and bone conduction hearing threshold test.
The basic principle of testing: firstly conduct air-guided audiometry, and first measure the bone conduction of the ear with a good hearing guidance threshold. The non-test ear should be masked when the bone is measured and listened.
Diagnosis
Diagnosis of tympanosclerosis
diagnosis:
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis:
Should be associated with ear sclerosis, adhesion otitis media, otosclerosis without otitis media, normal tympanic membrane, progressive deafness, identification is not difficult, but it is difficult to identify with adhesive otitis media, sometimes rely on surgical exploration to confirm the diagnosis.
Adhesive otitis media is also known as chronic catarrhal or fibrous otitis media. The adhesion is mostly located in the posterior part of the middle tympanic cavity. The tympanic membrane becomes thicker and adheres to the tympanic membrane. The ossicular bone can be adhered to the vestibular window alone or completely. The fibrous tissue embeds the tibia and the anvil bone together on the vestibular window, and the vestibular window. Can be partially or completely closed.
