Otoscopic findings in hypercholesterolemic subjects

We aimed to verify the extent of a previously cited relationship between tympanosclerosis and atherosclerosis by investigating subjects with dysfunction in lipid metabolism but no clinically apparent symptoms of atherosclerotic disease.

Forty hypercholesterolemic patients were submitted to Doppler ultrasound examination of carotid and vertebrobasilar arterial regions; results were matched to otoscopic findings. Otoscopy was performed to evaluate for sclerotic plaques of the tympanic membrane, which represent the most common, clinically non-relevant manifestation of tympanosclerosis. A control group of 41 randomly chosen healthy subjects were also included.

Nine (22.5%) of 40 subjects with hypercholesterolemia showed tympanic sclerotic plaques at otoscopy compared to 2 (4.9%) out of 41 control patients. This difference was statistically significant (p = 0.02). An even stronger association (p = 0.01) was found between tympanic and arterial plaques in the study group, as we identified tympanic sclerotic plaques in 7 (41.2%) out of 17 patients with positive Doppler ultrasound signals for arterial plaques. Only two (8.7%) out of 23 subjects without plaques on Doppler ultrasound examination had tympanic sclerotic plaques.

The results of this study confirm the existence of a link between tympanosclerosis and atherosclerosis. To our knowledge, this is the first report of a link between these findings in preclinical atherosclerotic conditions.