As a child, did you ever take a tumble on the playground and come away with a few scrapes? It may have hurt in the moment, but most of those little scrapes and cuts likely healed themselves in time, but some might have left a permanent mark in the form of scars on your arms or legs.

Just as you can develop a scar on your knee, you can also develop scars on your eardrums through a condition called tympanosclerosis. Typically occurring after injury or surgery, this scarring may lead to a conductive type hearing loss. While it may sound scary to develop unseen scars in your ears, there are treatment options to address the scarring and related hearing loss. 

• Tympanosclerosis is a condition characterized by scarring on the eardrum, or tympanic membrane. Scars can cause the buildup of calcium deposits on the eardrum.
• Symptoms of tympanosclerosis include hearing loss or muffled hearing, ear pain, ear swelling, and chalky white buildup on the eardrum.
• Tympanosclerosis is diagnosed and treated by a hearing care professional or ENT doctor.
• Ear surgery, trauma to the ear, ear infections, or cholesteatomas can cause tympanosclerosis.
• Treatment typically involves surgery to remove the scarred tissue, and hearing aids if hearing loss is present due to tympanosclerosis.

A simple tympanosclerosis definition is scarring on the eardrum, also known as the tympanic membrane. Located at the beginning of the middle ear, this thin, cone-shaped layer of tissue performs two important roles for the ears: protecting the sensitive structures of the middle and inner ear from dirt and debris and assisting in processing sound waves to hear. When the tympanic membrane becomes scarred—whether from injury or surgery—calcium deposits can build up, causing the eardrum to harden and become less flexible. This scarring appears as bright, chalk-white marks on the eardrum. Tympanosclerosis bilateral is when both eardrums are affected by scarring.

Tympanosclerosis may also be referred to as myringosclerosis. Both conditions are characterized by calcium deposits on the eardrum; however, myringosclerosis only affects the eardrum, while tympanosclerosis is a broader term, as scarring may affect both the eardrum and other parts of the middle ear. 

Tympanosclerosis symptoms can vary greatly from person to person, and in cases of mild tympanosclerosis, a person may not exhibit any symptoms at all. General symptoms and signs of the condition include:

• Earaches and ear pain, similar to the feeling of an ear infection
• Hearing loss or muffled hearing
• Swelling or inflammation in the ear

Chalky white buildup on the eardrum is another classic symptom of tympanosclerosis, but it is only detectable by healthcare professionals who can look inside your ears with special tools. If you experience ear pain or some degree of hearing loss, schedule an appointment with a hearing care professional (HCP) to examine your ears directly and determine if tympanosclerosis may be affecting your hearing. 

Because of the condition’s relation to the eardrum, hearing loss and tympanosclerosis often go hand in hand. A healthy, unscarred eardrum is composed of three layers of translucent, flexible connective tissue. The flexibility of this membrane is crucial to the hearing process. When sound waves reach the eardrum, the waves cause the membrane to vibrate. These vibrations travel to three tiny bones in the middle ear (known as ossicles), which magnify the vibrations and essentially tap on the cochlea. That tapping spurs the creation of electrical impulses that are carried via the auditory nerve to the brain and processed as sound.

When tympanosclerosis causes the eardrum to harden and lose its flexibility, the eardrum is unable to fully vibrate, preventing sound from properly traveling further into the cochlea and to the brain. The degree of hearing loss a person with tympanosclerosis might experience depends on how much scarring is on the eardrum, but it can range from mild to moderate.  Because of the damage it can cause to the middle ear, tympanosclerosis hearing loss can be classified as conductive hearing loss.

However, despite the risk of hearing loss associated with tympanosclerosis, several treatment options can repair the scar tissue in the eardrum and, in some cases, restore hearing.

Can tympanosclerosis cause tinnitus? It’s possible. Along with the potential for hearing loss, tympanosclerosis can also cause tinnitus symptoms and a feeling of fullness in the ear, which may cause muffled hearing.

While the exact causes of tympanosclerosis are still unknown, many healthcare professionals believe it’s related to chronic autoimmune conditions and abnormal healing in the ear. Health conditions that may contribute to tympanosclerosis include:

The tympanosclerosis treatment your HCP or doctor prescribes depends on the cause of the condition.

If your tympanosclerosis symptoms include ear pain caused by otitis media, you may find relief through ear infection symptom treatments. This can include over-the-counter pain medications, warm compresses on the ear, or drying ear drops. Never use cotton swabs to clean your ears out—they will only push fluid or debris deeper into your ears and worsen infections. In most cases, ear infections clear on their own, and your ear pain will go away with time.

However, if your symptoms include hearing loss, only measures like surgery or hearing aids can provide true tympanosclerosis relief. These symptoms point to a more severe case of the condition, which must be addressed with the help of an ENT doctor.

If hearing aids or surgery are the recommended courses of action, but you’re concerned about the price tag, you can determine hearing aid and/or tympanosclerosis surgery cost in conjunction with your healthcare provider, facility billing team, and insurance carrier.

To receive a tympanosclerosis diagnosis, your primary care provider will likely refer you to an otolaryngologist to specifically review your symptoms. They will take your medical history and perform several physical and audiological exams, which can include:

• Ear exam: Using an otoscope—a tool that uses light and magnification to view inside the ear—your doctor will look at the eardrum for any signs of scarring.
• Audiometric exam: If your symptoms include hearing loss, your doctor will likely perform an audiogram to test your hearing levels. Using a pair of headphones or insert phones, you will listen to sounds at different frequencies and indicate which you can hear; your HCP will analyze the results to determine your hearing range.
• Weber exams: To determine the degree to which tympanosclerosis is affecting hearing loss in each ear, your HCP may perform a Weber exam to identify unilateral hearing loss. The test involves striking a tuning fork and placing it on the top of a person’s head to determine in which ear the sound is louder.
• CT scans: If standard ear exams don’t show signs of the condition, tympanosclerosis may appear on CT scans as web-like forms of calcified masses in the middle ear.

If you notice that regular noises sound muffled, quiet sounds are more difficult to hear, or your ability to hear is steadily decreasing, it’s time to discuss your symptoms with a hearing specialist. They can understand your symptoms, examine your ears, and suggest the appropriate next steps. Schedule an appointment with a hearing care professional at your local Miracle-Ear to discuss your hearing health.