Related Experiment Video
Updated: Aug 6, 2026
Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
Published on: February 29, 2020
Diagnosis and management of the lateralized tympanic membrane
1Department of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, USA.
Objective:
Lateralization of the tympanic membrane (TM) is associated with significant morbidity. In a series of 14 patients, we make observations to illuminate this condition for the diagnosing and treating physician.
Study Design:
Chart review of 14 consecutively treated patients.
Methods:
We analyzed the presenting signs and symptoms, etiology, audiometric data, and operative findings of patients with a lateralized tympanic membrane (TM).
Results:
The etiology was postsurgical in 13 patients (there were four aural atresia repairs and nine tympanoplasties), with 2 patients having had multiple previous surgeries. Presentation averaged more than 5 years after the latest surgery. Presenting symptoms included hearing loss in 10, tinnitus in 3, vertigo in 3, and otorrhea in 2 patients; 3 patients were nonsymptomatic at the time of presentation. The average air-bone gaps were 39 dB before treatment and 29 dB after treatment. Operative findings included cholesteatoma in six patients. Eight patients healed with the TM in the normal position; one had TM retraction, one had a TM perforation, and three had a recurrent lateralization.
Conclusion:
The lateralized TM is primarily, but not necessarily, a complication of otological surgery. It may be associated with considerable morbidity, including hearing loss and cholesteatoma. Patients may present several years after their surgery, occasionally as an incidental finding. Surgical repair is often necessary for significant underlying disease, but re-establishment of a normal TM can be challenging.
Insights
Lateralization of the tympanic membrane (TM) often follows ear surgery and can cause hearing loss and cholesteatoma. Surgical repair may be needed but can be challenging.
Area of Science:
- Otolaryngology
- Surgical Pathology
Background:
- Lateralization of the tympanic membrane (TM) is a recognized complication associated with significant patient morbidity.
- Understanding the etiology and presentation of lateralized TM is crucial for effective diagnosis and treatment.
Purpose of the Study:
- To analyze the clinical presentation, etiology, and outcomes of patients with a lateralized tympanic membrane (TM).
- To provide insights for physicians diagnosing and treating this condition.
Main Methods:
- A retrospective chart review was conducted on 14 consecutively treated patients with a lateralized TM.
- Analysis included presenting signs and symptoms, etiology, audiometric data, and operative findings.
Main Results:
- The primary etiology was postsurgical (13/14 patients), often years after procedures like aural atresia repair or tympanoplasty.
- Common symptoms included hearing loss (10/14), tinnitus, and vertigo; cholesteatoma was found in six patients.
- Surgical outcomes varied, with 8/14 patients achieving normal TM position, while others experienced retraction, perforation, or recurrent lateralization.
Conclusions:
- Lateralized TM is predominantly a postsurgical complication but can occur idiopathically.
- Significant morbidity, including hearing loss and cholesteatoma, is associated with this condition.
- Surgical intervention is often required, but achieving a normal TM position can be difficult.
