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Histology of the perforated tympanic membrane and its muco-epithelial junction

T h Somers1, V Houben, G Goovaerts

  • 1University Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Sint-Augustinus Hospital, Antwerp-Wilrijk, Belgium.

Clinical Otolaryngology and Allied Sciences
|April 1, 1997
PubMed

Insights

Histological examination of human tympanic membranes revealed common abnormalities like inflammation and fibrosis. Surgeons must address ingrowing epithelium during myringoplasty to prevent complications.

Area of Science:

  • Otolaryngology
  • Histopathology
  • Surgical Anatomy

Background:

  • Perforated tympanic membranes often require surgical repair.
  • Myringoplasty involves reconstructing the eardrum, frequently using tympanic allografts.
  • Understanding the histological characteristics of the native tympanic membrane is crucial for successful surgical outcomes.

Purpose of the Study:

  • To histologically investigate human tympanic membranes with central perforations prior to allograft reconstruction.
  • To identify common pathological findings in these membranes.
  • To inform surgical techniques for myringoplasty, particularly regarding epithelial ingrowth.

Main Methods:

  • Histological analysis of 30 human tympanic membrane specimens.
  • Specimens were obtained from consecutive, unselected myringectomy surgeries before tympanic allograft reconstruction.
  • Detailed examination for thickening, inflammation, fibrosis, tympanosclerosis, hyperkeratosis, rete ridges, epithelial inclusions, and epithelial junctional position.

Main Results:

  • Excessive thickening observed in 73% of tympanic membranes.
  • High prevalence of histological abnormalities: inflammation (97%), excessive fibrosis (97%), tympanosclerosis (80%), hyperkeratosis (83%).
  • Medial positioning of the muco-epithelial junction (30%) and squamous epithelial invasion into the middle ear (7%) were noted.

Conclusions:

  • Human tympanic membranes undergoing myringoplasty exhibit significant pathological changes.
  • Squamous epithelial ingrowth and abnormal junctional positioning pose a risk during tympanoplasty.
  • Surgeons must meticulously examine the medial tympanic membrane surface to excise ingrowing epithelium, optimizing surgical success.

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