CHRONIC MYRINGITIS

Chronic deep EAC and drum ulceration

© Bruce Black MD

Myringitis on the posterior scutum. The cause of myringitis is uncertain. Although early, this case may be resistant to

conservative management. © Bruce Black MD

Oedematous myringitis of the upper pars tensa. Reduce with topical steroid-antibiotic treatment, then cauterise with

AgNO3, or trichloroacetic acid. © Bruce Black MD

Myringitis of the pars flaccida. Manage conservatively, avoid aggressive cautery on the relatively fragile membrane

of this area. © Bruce Black MD

Active, oedematous myringitis of much of the pars tensa. The extent of disease may prolong treatment substantially.

© Bruce Black MD

Myringitis frequently complicates chronic otitis media. A small posterior pars tensa perforation is surrounded by

myringitis covering much of the posterior drum. © Bruce Black MD

Glistening myringitis surrounding a subtotal drum perforation, best served by complete excision during a

myringoplasty to repair the drum. © Bruce Black MD

Velvety myringitis covering the drum and extending into the posterior canal. Post-tympanoplasty. An inclusion cholesteatoma is seen above. Excise and graft. © Bruce Black MD

Marginal myringitis around a larger central pars tensa perforation. Excise during drum repair surgery.

© Bruce Black MD

Diffuse thickened myringitis covering the entire pars tensa. Unlikely to respond to conservative measures. Dissect off

and use an onlay graft to repair the drum. © Bruce Black MD

Diffuse myringitis of the left pars tensa, extending into the upper deep EAC. Clearance of the drum and excision of the

EAC component is required, plus extended grafting. © Bruce Black MD

Extensive myringitic encroachment has denuded the deep canal of squamous epithelium. Total clearance and split

skin grafting will be necessary. © Bruce Black MD

Advanced myringitic fibrosis of the deep canal has rendered the drum featureless. Removal, canal widening and SSG

repair needed. © Bruce Black MD

Advancing fibrotic obliteration of the deep canal by chronic myringitic change. Full canalplasty required.

© Bruce Black MD

Progressive cicatrising fibrosis of the deep canal. Irreversible, split skin grafting canalplasty necessary. May

recur after surgery. © Bruce Black MD

Subtotal deep canal closure. This will be followed by complete closure and a possible 40-50 db. conductive loss.

© Bruce Black MD

Obliteration of the deep canal. A substantial myringitic fibrotic mass is filling the deep canal.

© Bruce Black MD

Complete deep canal obliteration. Fibrotic change is maturing and the myringitic areas shrinking.

© Bruce Black MD

Burnt-out myringitic stenosis with a plug of keratin filling a pinhole deep canal.

© Bruce Black MD

CHRONIC MYRINGITIS��Chronic deep EAC and drum ulcerationMyringitis on the posterior scutum. The cause of myringitis is uncertain. Although early, this case may be resistant to conservative management.Oedematous myringitis of the upper pars tensa. Reduce with topical steroid-antibiotic treatment, then cauterise with AgNO3, or trichloroacetic acid. Myringitis of the pars flaccida. Manage conservatively, avoid aggressive cautery on the relatively fragile membrane of this area.Active, oedematous myringitis of much of the pars tensa. The extent of disease may prolong treatment substantially.Myringitis frequently complicates chronic otitis media. A small posterior pars tensa perforation is surrounded by myringitis covering much of the posterior drum. Glistening myringitis surrounding a subtotal drum perforation, best served by complete excision during a myringoplasty to repair the drum.�Velvety myringitis covering the drum and extending into the posterior canal. Post-tympanoplasty. An inclusion cholesteatoma is seen above. Excise and graft.Marginal myringitis around a larger central pars tensa perforation. Excise during drum repair surgery.Diffuse thickened myringitis covering the entire pars tensa. Unlikely to respond to conservative measures. Dissect off and use an onlay graft to repair the drum.Diffuse myringitis of the left pars tensa, extending into the upper deep EAC. Clearance of the drum and excision of the EAC component is required, plus extended grafting.Extensive myringitic encroachment has denuded the deep canal of squamous epithelium. Total clearance and split skin grafting will be necessary. Advanced myringitic fibrosis of the deep canal has rendered the drum featureless. Removal, canal widening and SSG repair needed.Advancing fibrotic obliteration of the deep canal by chronic myringitic change. Full canalplasty required.Progressive cicatrising fibrosis of the deep canal. Irreversible, split skin grafting canalplasty necessary. May recur after surgery.Subtotal deep canal closure. This will be followed by complete closure and a possible 40-50 db. conductive loss.Obliteration of the deep canal. A substantial myringitic fibrotic mass is filling the deep canal.Complete deep canal obliteration. Fibrotic change is maturing and the myringitic areas shrinking.Burnt-out myringitic stenosis with a plug of keratin filling a pinhole deep canal.