On a routine otoscopic exam, you see the tympanic membrane pictured below. How would you describe this finding? What is it? What causes it?
Tympanosclerosis is a condition caused by hyalinization and subsequent calcification of subepithelial connective tissue of the tympanic membrane and middle ear, sometimes resulting in hearing loss. It is most often a sequela of chronic middle-ear infection or tympanostomy tube placement. Tympanosclerosis affects the tympanic membrane either alone, in which case it is given the name myringosclerosis, or in association with other parts of the middle-ear cleft.
In contrast, otosclerosis is a condition of the middle ear in which there is progressive pathologic bone remodeling of the ossicles, most often resulting in bilateral conductive hearing loss. Tinnitus and vertigo can also occur. It is most often genetically inherited, but can also occur spontaneously; measles exposure is a known risk factor for developing otosclerosis. Otoscopic exam is typically normal.