Clinicopathologic studies in tympanosclerosis.
Light-and electron-microscopic studies of the tissue from middle ears diagnosed as having tympanosclerosis, adhesive otitis media, postinflammatory ossicular fixation, and chronic otitis media revealed more or less similar findings of inflammatory response and healing. The histopathologic findings of "whitish sclerotic masses," especially around the ossicular chains, were due to fibrosis of submucosal connective tissue with hyalinization and calcification and/or metaplasia of mucosal epithelium. Longstanding and repeated undrained suppurative or nonsuppurative effusions would promote progressively more dense and avascular fibrous adhesions in the tympanum. The extensive fibrous changes in the tympanum would be a consequence of inadequate antibiotic therapy for middle ear inflammation and effusion. A new diagnostic term of tympanomastoidfibrosis is proposed to explain these clinical and histopathologic conditions as a replacement for the terms tympanosclerosis, adhesive otitis media, inflammatory ossicular fixation, and so on.