A 35-year-old woman stopped by the WiscMed booth at the 2022 American Academy of Pediatrics (AAP) tradeshow. She told WiscMed staff that she had “interesting ears.” She had a history of many years of significant allergies that she attributed to her ear changes. She does not have any ear pain, nor does she have any hearing loss. The following image of her right ear is obtained with the Wispr digital otoscope.
What change to her ear drum is notable?
The woman has diffuse sclerosis of her eardrum.
Sclerosis of the tympanic membrane is caused by changes to the submucosa of the middle ear. Thought to be a cellular response to insult, the “whitish” appearance is associated with calcium deposits. Hearing is generally not affected. Sclerosis is usually caused by infection or by trauma, the trauma is often the result of the placement of ventilation tubes. In the case of sclerosis secondary to ventilation tubes, the pattern is often localized. In this case, given the history report of the patient, it’s possible that diffuse sclerosis represents a more generalized immune response to recurrent allergic episodes.
Compare diffuse sclerosis to localized sclerosis to normal.