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Temporal bone histopathology in chronically infected ears with intact and perforated tympanic membranes
Author(s) -
Da Costa Sady S.,
Paparella Michael M.,
Schachern Patricia A.,
Yoon Tae H.,
Kimberley Barry P.
Publication year - 1992
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-199211000-00005
Subject(s) - tympanosclerosis , middle ear , medicine , temporal bone , perforation , cholesteatoma , tympanic membrane perforation , tympanum (architecture) , chronic suppurative otitis media , granulation tissue , otitis , ossicles , effusion , anatomy , stapes , malleus , tympan , facial canal , tympanoplasty , surgery , wound healing , materials science , metallurgy , punching
Chronic suppurative otitis media has been clinically defined as a chronic discharge from the middle ear in the presence of a perforation of the tympanic membrane. However, irreversible tissue pathology in the middle ear or mastoid can occur behind an intact tympanic membrane. One hundred forty‐four human temporal bones with chronic otitis media were divided into two groups: those with perforated (28) and those with nonperforated (116) tympanic membranes. The histopathological findings of their middle ears were compared. Granulation tissue in various degrees was the most prominent pathological feature. It was observed in 96% of temporal bones with perforation of the tympanic membrane, and in 97% of those without perforation. Also found were ossicular bony changes (96% with perforation; 90.5% without), middle ear effusion (93% with perforation; 89% without), cholesterol granuloma (21% with perforation; 12% without), cholesteatoma (36% with perforation; 4% without), and tympanosclerosis (43% with perforation; 20% without). This study shows that the histopathological changes of the middle ear are similar in temporal bones with and without perforation of the tympanic membrane. The clinician should, therefore, be aware that an intact tympanic membrane does not necessarily preclude the presence of gross pathological changes of the middle ear cleft.