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OBJECTIVES: So far many classifications have been made to describe anatomical, clinical, histological amd surgical characteristics of the tympanosclerosis. However, these classifications do not predict the prognosis of the tympanosclerosis surgery. Hereby we propose a classification system for tympanosclerosis which helps in predicting the prognosis for tympanosclerosis surgery.
METHODS: In this randomized prospective study conducted from Dec’1996 to till today, 236 patients were considered. Factors like history of ear discharge, type of middle ear disease, extent myingosclerosis, middle ear tympanosclerosis, ossicular mobility and hearing status were assessed. A classification system was developed which took consideration of each factor which could influence the outcome of tympanosclerosis surgery. Patients were grouped into four stages such as favorable, moderate, severe and risky, depending on various clinical-audiological findings. Surgery was tailored according to the stage of the disease.
RESULTS : This classification helped us to predict the prognosis for tympanosclerosis surgery majority of the times. This was helpful in explaining the patients about the possible outcome and prepare them mentally for a possible second surgical procedure like stapedotomy. This also helped us in planning and staging the disease as well as prepare ourselves mentally for required surgical technique and avoid extensive surgery, when not required.
CONCLUSIONS: This classification takes into consideration all the factors which can influence outcome of tympanosclerosis surgery and is helpful in the management of tympanosclerosis.
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