Clinical analysis of 118 patients with tympanosclerosis

objective To study the incidence of tympanosclerosis(TS) and the major risk factors of hearing loss.Method A total of 118 TS patients(137 ears) were compared with 265 patients with chronic otitis media(COM)(311 ears) for gender,age and course of disease.The disease regions and hearing loss of the TS patients were analyzed.Results TS showed higher prevalence in women of older ages.Sclerosis was seen most frequently in the tympanic membrane,followed by the malleus,incus,incudomalleolar joint,other regions,ariticulus incudostapedius and stapes.The patients with sclerosis or deterioration in the ossicular chain had worse hearing loss than the other patients.Carhart notch occurred in 45 ears(32.85%),an incidence similar to that of inverted "V"-shaped curve of air-conduction audiometry near 2 kHz(47 ears,34.31%).The factors contributing to the hearing loss,listed in the order of their importance,included pathologies in the incus,malleus,incudomalleolar joint,ariticulus incudostapedius,stapes,other regions,tympanic membrane,and gender.Conclusions Female patients may had increased risk of TS.The presence of Carhart notch and inverted "V"-shaped curve in air-conduction audiograph may indicate myringosclerosis or ossicular chain sclerosis.Abnormal ossicular chain is the leading factor contributing to hearing loss.