Fibroma of the tympanic membrane

A primary tumor of the tympanic membrane is very rare. Herein, we describe a patient with a thick tympanic membrane that caused progressive hearing loss. The patient was treated with total resection of the tympanic membrane and was diagnosed with fibroma after histopathologic examination. There was no evidence of recurrence 2 years after the operation, and the patient's hearing was normal. Fibroma may arise in the tympanic membrane and should be regarded as a possible cause of the mass of the tympanic membrane.     

Paraganglioma of the tympanic membrane

Von Haller, in 1743, first described the carotid body and was so impressed with the richness of its innervation that he called it 'ganglion minutum', thinking it to be a sympathetic ganglion. Valentine, in 1840, saw a peculiar structure in the tympanic canaliculus in which a nerve cell was present and called it 'gangliolum tympanicum'. Almost 100 years later, in 1941, Stacey Guild reported the presence of some structures near the wall of the jugular bulb and described them as 'glomus jugulare'. Following this report, Rosenwaser (1945) and Otani were able to make a correct classification of these tumours in the middle ear. There have been innumerable reports of them and various authors have called them by various names. We report here a case of paraganglioma which was localized entirely to the tympanic membrane without involving any other part of the middle-ear cleft.     

Prognosis and outcome of the tympanic membrane flap at traumatic tympanic membrane perforation edge

This study aimed to retrospectively evaluate the prognosis and outcome of tympanic membrane perforations with a particular focus on the fate of the perforation edge flaps.Chart records of 329 patients with a single ear traumatic tympanic membrane perforation were retrieved and analyzed. Of these patients, 70 were left to heal spontaneously, 93 received gelatin sponge patching treatment and 114 were subjected to otoendoscopic eardrum repair before gelatin sponge patching. The complete perforation closure rate at 3 months was 94.29% (66/70), 98.92% (92/93) and 98.24% (112/114) in the 3 groups, respectively, with no statistically significant difference (p = 0.608). The mean closure time was 28.2 ± 3.6 days in the spontaneous healing group, which was significantly longer than that in the sponge patching group (11.1 ± 2.1 days, p = 0.0017) and in the eardrum repair + sponge patching group (12.5 ± 1.9 days, p = 0.0032), while there was no significant difference between the 2 gelatin sponge patching groups (p = 1.86). The hearing ability improved in the 3 groups (6.4 ± 0.83, 7.2 ± 1.65 and 9.6 ± 2.37 dB, respectively), with no statistically significant difference (p >0.05). In the gelatin sponge patching group, new tympanic membrane tissue of the eardrum flap edge proliferated, and the contour of the eardrum flap was not obvious. In the eardrum flap repair group, the eardrum flap retracted to the perforation edge. In conclusion, the eardrum flap of the perforation edge does not have any obvious effect on the perforation closure so that it is unnecessary to conduct an intervention procedure on the flap in the clinical treatment.     

Isolated uncertain tympanic membrane findings. Central site of tympanic membrane cholesteatomas

Ohne Zusammenfassung     

Pulsion hernias of the tympanic membrane

A pulsion hernia of the tympanic membrane is an outwardly bulging, thin, atrophic area of the tympanic membrane. Those patients who develop pulsion hernias repeatedly autoinflate the middle ear and consequently maintain a positive middle ear pressure, which pushes the thin atrophic portion of the tympanic membrane laterally beyond the normal plane of the tympanic membrane. The thinness of the tympanic membrane over the pulsion hernia suggests that the herniation has developed through a pre-existing area of weakness where the fibrous middle layer has disappeared.     

Iontophoretic anaesthesia of the tympanic membrane

Anaesthesia of the tympanic membrane by iontophoresis of lidocaine is a painless and safe method for myringotomy and grommet insertion. Thirty-nine patients with serous otitis media and II patients with Ménière's disease had their tympanic membranes anaesthetized by iontophoresis of lidocaine; analgesia was perfect for all of them. In the patients with serous otitis media, the insertion of grommets was carried out easily and without pain. Major problems or complications have not been encountered during this study.     

Capillary hemangioma of the tympanic membrane

We report a case of capillary hemangioma of the tympanic membrane in a 51-year-old man with conductive hearing loss, otalgia, and otorrhea. On examination, the external auditory canal was obstructed with a hard, dark red tumor, and purulent discharge was observed. The infection was controlled with antibiotics, but hearing loss persisted. Therefore, transcanal resection was performed. The tumor was attached to the postero-superior quadrant, and arose from the lamina propria. Histologically, the tumor was composed of multiple capillary-sized vessels surrounded by fibrous connective tissue and diagnosed as capillary hemangioma. After surgical treatment, hearing loss was diminished, and there has not been any sign of recurrence for 3 years despite the positive surgical margin.     

Cavernous hemangioma of the tympanic membrane

Cavernous hemangioma seems to most frequently arise in the posterior portion of the external auditory canal. However, they rarely occur in the tympanic membrane. A 49-year-old male patient was referred for evaluation of right-sided pulsatile tinnitus that he'd experienced for the previous 2 years. Temporal bone computerized tomography showed an isolated soft tissue mass just lateral to the tympanic membrane. There was no evidence of bony erosion or middle ear invasion. The patient underwent excision of the mass using a postauricular approach. The mass was removed en bloc and the defect of the tympanic membrane was repaired by tympanoplasty type I. There was no recurrence after 1 year of follow-up.     

Fluorescein angiography of the tympanic membrane

Little is known about the dynamic vasculature of the tympanic membrane, despite the fact that it is within easy view of the otolaryngologist. An understanding of its blood supply dynamics may lead to a better understanding of the tympanic membrane's physiological properties and response to surgery. Also, certain patterns of blood flow may correlate with disease entities and be of diagnostic value. Currently, we have done 30 fluorescein angiograms of the tympanic membrane. The fluorescein angiograms from a normal ear and from ears with several types of ear pathology are described.