Summary
Myringitis granulosa is not a rare pathologic condition of the tympanic membrane. However, the condition can be misdiagnosed as chronic suppurative otitis media, since intermittent purulent discharge is the commonest symptom in both disorders. Although the clinical features of myringitis granulosa have been well described by several authors, its pathogenesis is still obscure. In this study, 40 cases of myringitis granulosa were examined in detail to clarify the clinical features and the pathogenesis present. No drum perforations, no hearing impairments and normal X-ray findings indicated that myringitis granulosa had no relation to chronic suppurative otitis media. The other areas of the affected tympanic membrane, except for the site of granulation, showed such pathologic conditions as atrophy, clouding and calcifications. In these pathologic tympanic membranes, epithelial migration was disturbed to a high degree. We suggest that the granulation process on the tympanic membrane should be divided into two stages: (1) injury reaching the lamina propria of the tympanic membrane; and (2) disturbed epithelization of the tympanic membrane. The disturbance of epithelial migration of the tympanic membrane occurs with both stages.
Similar content being viewed by others
References
Clark IV (1946) Acute otitis externa in India. J Laryngol 61:586–593
Clawson JP, Litton WB (1971) The healing process of tympanic membrane perforations. Trans Am Acad Ophthalmol Otolaryngol 75:1302–1312
Hochfilzer JJ (1945) Myringitis granulosa. Laryngoscope 55:509–518
Hoshino T, Yano J, Ichimura K, Hashimoto H, Nozue M (1982) Arch Otorhinolaryngol 234:219–223
Johnston CM (1948) The incidence and treatment of infective ear disease in factory employees. Br Med J 2:4589–4599
Khalifa MC, Fouly SE, Bassiouny A, Kamel M (1982) Granular myringitis. J Laryngol 96:1099–1101
Makino K, Amatsu M (1986) Epithelial migration on the tympanic membrane and external canal. Arch Otorhinolaryngol 243:39–42
Moffett TMAJ (1943) Granulating myringitis. An unusual affection of the ear drum. J Laryngol 58:453–456
Pulec JL (1980) Chronic granular myringitis. In: Paparella MM, Shumrick DA (eds) Otolaryngology: the ear, vol 2. Saunders, Philadelphia, pp 1391–1393
Punt NA (1949) Otitis externa granulosa. Br Med J 1:989–990
Reijnen CJ H, Kuijspers W (1971) The healing pattern of the drum membrane. Acta Otolaryngol (Stockh) [Suppl] 287:1–74
Saad EF (1977) The epidermis of the drumhead in some otologic conditions. Arch Otolaryngol 103:387–388
Sade J (1962) Granular external otitis. Ann Otol Rhinol Laryngol 71:391–396
Siirala U (1953) Myringitis granulosa. Acta Otolaryngol (Stockh) [Suppl] 109:136–139
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Makino, K., Amatsu, M., Kinishi, M. et al. The clinical features and pathogenesis of myringitis granulosa. Arch Otorhinolaryngol 245, 224–229 (1988). https://doi.org/10.1007/BF00463932
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00463932