TYMPANOSCLEROSIS (Greek tympanon drum + sclerosis; synonym: pseudootosclerosis, otosclerosis, adhesive otitis, otosclerosis) — the growth of connecting fabric in a mucous membrane of a middle ear with the subsequent its hyalinosis, calcification and ossification leading to defeat of the zvukoprovodyashche-shchy device of an ear and development of relative deafness.
The term «tympanosclerosis» is for the first time offered in 1869 to A. F. Troltsch for designation of the cicatricial changes in a drum cavity which arose after inflammatory process on average to fish soup. Later, after works of A. Polittser who described morphology of these changes on average to fish soup for designation of similar states began to use the term «adhesive otitis». In process of further studying of this problem other terms appeared: «adhesive process», «residual otitis», «otosclerosis», «dry Qatar», «not purulent average otitis», «pseudootosclerosis». The abundance of the terms designating actually same changes on average to fish soup induced to address the umbrella term again — «tympanosclerosis». Tsellner and Beck (F. Zollner, S. of Beck, 1955) considering that iod T gave to this term special treatment. it is necessary to understand the special, seldom found form of poslevosialitelny conditions of a middle ear different from adhesive otitis an originality morfol. changes in a drum cavity — dystrophy of connecting fabric with adjournment of salts of calcium and a new growth of a bone.
Question of an etiology and pathogeny of T. finally it is not solved. Assume that emergence of the changes in a drum cavity characteristic of T., it can be connected with an allergic background, on Krom the inflammation of a middle ear proceeds. Otokhirurgami is saved up the considerable material characterizing T. as a special type of effects, purulent process on average to fish soup (see Otitis), at Krom a mucous membrane of a middle ear (see) becomes dense, compact; vibration ability of a tympanic membrane (see) and a ring linking of a stirrup is broken, in a drum cavity the commissures breaking chain dynamics of acoustical stones, a tympanic membrane develop; as a result of process arises relative deafness (see).
At T. on walls of a drum cavity stratifications, most often by thick layer the verkhnezadny departments of a drum cavity covering the cape with N are formed. Coloring their whitish-yellow, pulled surface; on a consistence these stratifications can be compared to the stiffened wax or paraffin. They easily act a sharp retractor; sometimes on these stratifications there is a print of acoustical stones. In some cases there is a destruction of the subject bone — a wall of the channel of a facial nerve, a long leg of an anvil, a stirrup.
Allocate two forms T.: limited and widespread. At a limited form timpanosklerotichesky stratifications occupy only certain sites of a tympanic membrane and walls of a drum cavity, are located in a dimple of a window of a threshold, 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, the chain of acoustical stones is immured in a cut. At microscopic examination the picture of fibrosis and a hyalinosis with lipoid infiltration, changes of collagenic fibers, deposits of salts of calcium comes to light.
The main complaint, to-ruyu patients with T show. — sharp resistant relative deafness in the absence of suppuration from an ear. Otoskopicheski usually comes to light extensive perforation of a tympanic membrane with reinforced edges, through to-ruyu are sometimes visible typical for T. stratifications; in some cases there is an extensive atrophic hem. Most authentically manifestations of T. can be found by means of an operative microscope (see).
To lay down. actions come down to the operative measure directed to improvement of hearing. Features of operation are caused by the nature of process, its prevalence, rate of decay appreciate acoustical stones and a tympanic membrane. During operation delete the stratifications described above at the maximum shchazheniye of a chain of acoustical stones and a mucous membrane of a drum cavity.
After operation chain dynamics of acoustical stones is often recovered; in these cases the forecast favorable, as T. usually does not recur. At a common form because of big destructive changes on average to fish soup, emergence of granulations on site remote timpanosklerotichesky stratifications the forecast less favorable.
Bibliography: Ovchinnikov Yu. M. Features of operative measures at a timpanoyekleroza, Vestn. otorinolar., Kya 4, page 25, 1966; To Khans and A. R. O ditch of classification of a tympanosclerosis, Zhurn. ushn., nose. and throats, Bol., No. 5, page 30, 1964; F e of 1 i t about A. Histopatogenesis of tympanosclerosis, J. Laryng., v. 93, p. 25, 1979; Martin H. et Martin C. Tympanosclerose et trepanation labyrin-thique, Ann. Oto-laryng. (Paris), t. 96, p. 307, 1979; M0 llerP. Tympanosclerosis of the ear drum, Acta oto-laryng., v. 91, p. 215, 1981; Weichselbau-merW.u. Pauler G. Zur Tympanoskle-rose, Laryng., Rhinol., Qtol., Bd 58, S. 417, 1979; Zollner P. Tympanosclerosis, Arch. Otolaryng., v. 78, p. 538, 1963; Zollner F. u. Beck G. Die Paukensklerose, Z. Laryng., Rhinol., Otol., Bd 34, S. 137, 1955.
Yu. M. Ovchinnikov.