What tympanosclerosis is
The eardrum and middle ear can react to repeated inflammation by forming scar tissue that hardens with calcium. When it is limited to the eardrum it is called myringosclerosis; when it involves the middle ear and the hearing bones, it is called tympanosclerosis in the strict sense.
What it looks like
On examination, the eardrum shows white, chalky, horseshoe-shaped or patchy areas. The patches are harmless in themselves and do not need to be removed.
Causes
- Repeated acute middle ear infections.
- Chronic otitis media.
- Glue ear (otitis media with effusion).
- Ear tubes (grommets or ventilation tubes).
- Eardrum perforations and trauma.
See fluid in ear and ear tubes.
Tympanosclerosis after ear tubes
White patches on the eardrum are common after grommets. Research shows they are usually small and rarely cause meaningful hearing loss. The benefits of ear tubes in suitable children generally outweigh this risk.
Symptoms
- Often none: found during a routine ear check.
- Gradual hearing loss in one or both ears.
- Muffled hearing.
- Tinnitus.
- Ear discharge if there is an associated perforation or infection.
See muffled hearing.
How it affects hearing
Sound travels through the eardrum and three ossicles to the inner ear. A stiff eardrum causes little hearing loss, but deposits that lock the ossicles, especially the stapes, block sound transmission and cause conductive hearing loss. The inner ear itself is usually normal.
Diagnosis
- Otoscopy or ear microscopy to see the eardrum.
- Audiometry to measure hearing and the type of loss.
- Tympanometry to assess eardrum movement.
- CT scan in some cases, especially before surgery.
Tympanosclerosis vs otosclerosis
The names are similar but the conditions differ. Otosclerosis is abnormal bone growth around the stapes in the inner ear capsule, often inherited and without infections. Tympanosclerosis follows middle ear inflammation. Both can cause conductive hearing loss.
When no treatment is needed
Patches limited to the eardrum with normal hearing need no treatment, only routine follow-up if there is a history of ear problems.
Hearing aids
Hearing aids work well for conductive hearing loss and avoid surgery. They are often the first choice, particularly when both ears are affected or surgery is unlikely to help.
Surgery
- Tympanoplasty: repairing the eardrum and removing deposits.
- Ossiculoplasty: freeing or replacing the hearing bones.
- Stapedotomy: when the stapes is fixed.
Outcomes vary and deposits can recur, so the decision is individual and discussed with an ENT surgeon.
Prevention
Prompt treatment of ear infections, managing glue ear and protecting the ears from water when there is a perforation help limit damage. Most people with tympanosclerosis need nothing more than awareness and occasional hearing checks.
See perforated eardrum.
Tympanosclerosis in children
White patches are commonly found in children who have had grommets or repeated ear infections. In most children they do not affect hearing or speech development. Hearing checks are recommended if there are concerns about hearing, speech or school performance.
Flying, diving and swimming
Intact eardrums with tympanosclerosis do not usually prevent flying, swimming or diving. If there is a perforation, water should be kept out of the ear, and diving should be discussed with an ENT specialist.
Follow-up
People with tympanosclerosis and normal hearing do not need regular specialist follow-up. Those with hearing loss benefit from periodic hearing tests to check for change and to adjust hearing aids if needed.
Tinnitus and tympanosclerosis
Some people with conductive hearing loss notice ringing or buzzing, often more noticeable in quiet rooms. Treating the hearing loss with hearing aids or surgery often makes tinnitus less intrusive, and sound therapy can help.
See tinnitus treatment.
When to see an ENT specialist
- Hearing loss or muffled hearing.
- Persistent or smelly ear discharge.
- Ear pain or new tinnitus.
- Dizziness or facial weakness with ear problems.
- Sudden hearing loss: seek urgent help.
See sudden hearing loss.
Key points to remember
- Tympanosclerosis is scarring and calcium in the eardrum or middle ear.
- It follows infections, glue ear or grommets.
- Eardrum-only patches are usually harmless.
- Hearing loss is treated with hearing aids or surgery.
Questions about tympanosclerosis
These answers are general information and do not replace an examination or individual medical advice.
Is tympanosclerosis serious?
Usually not; most cases cause no symptoms.
Does tympanosclerosis cause hearing loss?
Only sometimes, mainly when the hearing bones are involved.
Can tympanosclerosis go away?
No, but eardrum patches usually need no treatment.
Is tympanosclerosis caused by grommets?
Grommets are a common cause, though patches are usually harmless.
What are the white spots on my eardrum?
Often tympanosclerosis from past ear infections.
Can hearing aids help?
Yes, they work well for conductive hearing loss.
Is it the same as otosclerosis?
No, otosclerosis is a different bone condition.
Can surgery fix tympanosclerosis?
Surgery can help some people, but results vary.
Does tympanosclerosis cause tinnitus?
It can, especially with hearing loss.
Can I swim with tympanosclerosis?
Yes, if the eardrum is intact.
Sources
- NHS · Glue ear
- NHS · Perforated eardrum
- MedlinePlus · Ruptured eardrum
- Browning GG et al. Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children. Cochrane Database Syst Rev. 2010
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.