Tympanolith under the Protiniculum - A Case Report

Volume 5 - Issue 1

Aditya Yeolekar¹*, Pooja Sancheti², Kiran J Shinde³

Received: August 03, 2020;   Published: August 20, 2020

DOI: 10.32474/SJO.2020.05.000201

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Abstract

Background: A tympanolith is a calcified body found impacted in mucosa of the middle ear. It is thought to be intrinsic deposition of calcium over a nidus of mucous plug whereas a foreign body is usually extrinsic.

Case Report: A young male with bilateral ear inactive chronic mucosal type of otitis media was posted for tympanoplasty. A full cuff incision and exploration of ear showed a smooth gritty hard stone stuck in the hypotympanum later confirmed to be a tympanolith. Middle ear anatomy of hypotympanum was studied with straight and angled endoscope. A type A configuration of bony crest of Protiniculum was found to be the reason for formation of mucus plug and lith.

Discussion: Tympanolith is a rare condition which is known to occur in a chronically discharging ear, due to calcium deposition on a mucus plug or biofilm formation. Tympanolith is a bony crest in hypotympanum with variable anatomy.

Conclusion: Every nook and corner of the middle ear should be inspected while doing a tympanoplasty to rule out tympanolith, foreign body or granulations. Either a full cuff incision microscopic tympanoplasty or an inspection of middle ear by angled endoscope in every case are suggested options.

Keywords: Tympanolith;protiniculum;protympnanum

Abstract| Introduction| Case Report| Discussion| Conclusion| Conflicts of Interests| Acknowledgements| References|