Clinical characteristics of granular myringitis treated with. Department of otolaryngology, free university hospital, amsterdam and. The middle ear disease should be excluded before diagnosing the gm, and the duration of symptoms should be more than one month blevins and karmody, 2001. Granular myringitis gm is a long term condition in which there is inflammation of the tympanic membrane in the ear and formation of granulation tissue within. The aspect of the tympanic membrane may allow for more descriptive diagnoses like bullous myringitis fluidfilled blisters surrounded by erythematous, opaque tissue, hemorrhagic myringitis intense redness and possibly blood clots, granular myringitis presence of granulation tissue 8, or combinations thereof 9. Granular myringitis and tympanic retraction pockets ento key. The granular myringitis gm is not uncommon though in medical literature it has been reported among the rarer conditions. On the other hand pathogenesis of myringitis bullosa is a very poorly understood and. Intractable chronic myringitis treated with carbon dioxide. Retrospective case series of 15 treated ears in consecutive patients between the ages of 6 and 14 years median age, 9. Granular myringitis is a long term condition in which there is inflammation of the tympanic membrane in the ear and formation of granulation tissue within the tympanic membrane.
The otologist should be aware of this clinical entity and its varied presentation. Tympanic membrane retraction, myringoplasty, myringomycosis and more. Otitis media is a group of inflammatory diseases of the middle ear. Granular myringitis as a differential diagnosis for. A prospective analysis of 50 patients with granular myringitis is presented majority of the patients complained of chronic intermittent olorrhoea, without any hearing loss. Article in spanish morais d, dalmau j, bernat a, ayerbe v. It is a type of otitis externa without treatment it can lead to narrowing of the ear canal. Laser therapy for refractory myringitis in children. Granular myringitis is a chronic inflammatory disorder characterised by lateral squamous deepithelialisation and granulation of the tympanic membrane in the absence of middleear disease. Objective an attempt to settle the controversies associated with granular myringitis gm including incidence, etiology, pathology, presentation, relation to chronic otitis media, and treatment study design retrospective setting tertiary referral center and private otology practice patients 94 patients presenting with gm over 28 years intervention diagnosis by otoscopy, audiometry. Myringitis treatment, causes, symptoms and prevention. Three cases of chronic granular myringitis cured by formalin.
Request pdf granular myringitis in children granular myringitis gm, described mainly in adults, is considered a rare infection of the tympanic membrane tm with possible involvement of. Granular myringitis is an uncommon inflammatory disorder of the tympanic membrane characterized by lateral squamous deepithelialization of the tm and granulation tissue over the involved area. This video presents the appearance of granular myringitis of left tympanic membrane the ear drum, without infection within middle ear space or mastoid air. Thirteen of the 15 patients 87% had myringotomy tube placement prior to diagnosis of myringitis, and 11 had a previous perforation 73%. The pars propria of the tympanic membrane is intact. Aim of the study is to observe clinical manifestations of granular myringitis gm treated with castellani solution. It has been referred to by other names in the literature, including granular myringitis, chronic epithelitis, otitis externa with granulations, granulomatous otitis externa, myringitis granulosa, chronic myringitis, and myringitis chronica. Myringitis definition of myringitis by medical dictionary. Dec 14, 2016 myringitis is a poorly understood inflammatory disease of the tympanic membrane and external auditory canal. Topical treatment using castellani solution with or without curettage of a granular lesion and. Myringitis middle ear, tympanic membrane, inflammation.
Granular myringitis generally is an external ear pathology extending to tympanic membrane and present as painless otorrhea, whereas the bullous myringitis is commonly associated with acute inflammation of middle ear cleft and present with. Eligible studies had to include at least 20 patients with a clinical diagnosis of granular myringitis based on clinical history and examination and lasting at least three weeks. Use our powerful automated land valuation estimates to get a quick and free estimate on any field get details on farmland sales, soils, crops, climate, and landowners all in one place stay in touch with the market by monitoring recent sales and listings. It is characterized by the presence of granulation tissue over the involved area in the absence of middle ear disease. Though they commonly present with ear discharge with or without pain, the etiology and the management principles differ. Three pilot studies of three potential treatments were conducted in a tertiary hospitals ent. Sep 14, 2020 corynebacterium species a retrospective study of cultures from adult and pediatric patients who presented with purulent and mucopurulent otologic infections found corynebacteria in 24 patients 33. Otology basic workshop jeffrey fichera, phd, pac physician. Granular myringitis is defined as a chronic inflammatory disorder, characterized by deepithelialization of the outer squamous layer of the tympanic membrane and replacement with granulation tissue in the absence of middle ear disease. Ent department, tygerberg academic hospital, cape town, south africa. The primary outcome measure was disease recurrence. Eleven myringoplasties were performed on 8 53% patients prior to the onset of granular myringitis 5 fascia, 2 fat, 2 cartilage, 1 paper patch, and 1 at an outside hospital that was unknown. Granular myringitis is similar to these medical conditions. Efficacy of diluted vinegar in treating granular myringitis.
Sep 29, 2018 bullous myringitis is a type of ear infection in which small, fluidfilled blisters form on the eardrum. Jun 01, 2010 sir, granular myringitis gm is a poorly understood condition characterised by desquamation of the tympanic membrane and the formation of granulations on the eardrum which may extend to the external auditory canal eac. It is a poorly understood disease and has received relatively little attention in the literature and easily mistaken for chronic otitis media due to similarity in clinical symptoms and findings. We have included 20 patients among which 15 men and 5 women of mean age, 49. This paper reports three cases of chronic granular myringitis treated with aural toilet using 0. The concept of an artificial tympanic membrane research. The differential diagnoses of chronic suppurative otitis media and polypoid myringitis are discussed, as well as the properties of formalin, its side effects, and the technique of toilet. A number of treatment options exist including putting vinegar in the ear, using antibiotic drops, and surgery. Its a painful condition, and if left untreated, it can do damage to your hearing. The databases were searched using the keywords granular myringitis, granular otitis externa, myringitis granulosa, and myringitis. Granular myringitis as a differential diagnosis for chronic. The literature includes many synonyms for cm, including myringitis granulosa, granular myringitis, polypoid myringitis, and tympanic membrane epithelitis. There is a proliferation of highly vascular granulation tissue with ulceration of the skin and seropurulent discharge. Granular myringitis international journal of otorhinolaryngology.
This article is within the scope of wikiproject medicine, which recommends that medicinerelated articles follow the manual of style for medicinerelated articles and that biomedical information in any article use highquality medical sources. The disease has rarely been described in the pediatricage patients. This study is designed to observe the clinical efficiency of castellani solution for the treatment of granular myringitis gm. Clinical efficiency of castellani solution for the. Dimensional stability of free fascia grafts wiley online library. Without treatment it can lead to narrowing of the ear canal. Granular myringitis generally is an external ear pathology extending to tympanic membrane and present as painless otorrhea, whereas the bullous myringitis is commonly associated with acute. Granular myringitis is a specific form of external otitis, it is characterized by granulation tissue on the lateral aspect of the tm with possible involvement of external auditory canal. Textbook of ear, nose and throat diseases, 11th edition. Mar 01, 2019 the other synonyms of gm include chronic myringitis, myringitis granulosa, granulomatous myringitis, granulating myringitis and granular external otitis bansal, 2017. Clinical characteristics of pediatric granular myringitis. Myringitis bullosa is a viral infection charac terised by. Granular myringitis and similar medical conditions.
Granular myringitis is the product of continuous scratching of the drum usually done with a feather. The extremely thin and delicate tympanic membrane tm is the first component of the middle ear conductive system. Data from the relevant articles were extracted using a predefined dataextraction form. Acceptable interventions included any topical or oral therapy or surgical management. Chronic myringitis is often mistaken for chronic otitis media. Topical treatment using castellani solution with or without curettage of a granular lesion and serial. Jan 31, 2021 granular myringitis gm is a long term condition in which there is inflammation of the tympanic membrane in the ear and formation of granulation tissue within. Jinnouchi o, kuwahara t, ishida s, okano y, kasei y, kunitomo k, et al. Such confusion prolongs the initiation of appropriate management and sometimes leads to needless tympanomastoid surgery. Clinical characteristics of granular myringitis treated. The other synonyms of gm include chronic myringitis, myringitis granulosa, granulomatous myringitis, granulating myringitis and granular external otitis bansal, 2017. Reference blevins and karmody 1 reference kunachak 3 studies estimate the prevalence to be around 1.
Granular myringitis is a localized chronic inflammation on the lateral surface of the tympanic membrane. Pdf the granular myringitis gm is not uncommon though in medical literature it has. Otoscopy and bacteriologic and histopathologic studies. Index terms starting with m myringitis index terms starting with m myringitis myringitis h73. Kamel skip to main content accessibility help we use cookies to distinguish you from other users and to provide you with a better experience on our websites. Gm is characterized by granulation tissue on the outer surface of the tympanic membrane tm with or without the. Granular myringitis gm is considered a rare infection of the tympanic membrane tm that is marked by granulation tissue formation. Conservative treatment in the form of local ear drops, cauterisation of the lesion and systemic antibiotics was successful only temporarily. Clinical efficiency of castellani solution for the treatment. Medical conditions similar to or like granular myringitis. Granular myringitis gm is a chronic inflammation that is confined to the squamous layer of the tympanic. Granular myringitis myringitis granulosa is a specific form of otitis externa. Tcell large granular lymphocytic leukaemia associated with rheumatoid arthritis.
One of the two main types is acute otitis media aom, an infection of rapid onset that usually presents with ear pain. Granular myringitis is a chronic disorder characterised by lateral squamous deepithelialisation and granulation of the tympanic membrane. A 4year prospective study on all children with gm in a primary otolaryngology practice affiliated to a tertiary academic medical center. A horizontal section through the tympanic membrane of the right ear of a 32yearold man shows focal granular myringitis. A novel classification and staging system to address. Granular myringitis gm is considered an uncommon infection of the tympanic membrane tm with possible involvement of the external ear canal. We present the application and initial results of a co 2 laser technique for the treatment of medically refractory chronic granular myringitis cgm. The aim of this study was to describe the clinical characteristics of the disease in children. Myringitis or bullous myringitis is the inflammation of the tympanic membrane that can cause blisters on the eardrum. Please visit the project page for details or ask questions at wikipedia talk.
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