Tympanosclerosis: clinical implications of the theory of pathogenesis.

Tympanosclerosis is a preventable disease. Its elimination is more the responsibility of the pediatrician and general practitioner than the otolaryngologist's. The education of our colleagues is the most effective way of possibly eliminating this disease process. Cholesteatoma and tympanosclerosis may have similar causative factors, but certainly have different pathogenic developmental patterns; their occurrence together in otologic disease is coincidental. The mechanism of this disease process shows that the subepidermal and submucosal connective tissue layers of the eardrum are the ones involved. The cure for tympanosclerosis may be achieved more easily than its amelioration. This may seem like a strange paradox, but cure is intimately bound up with prevention which is the key for the clinical significance of this theory of pathogenesis. The pediatrician and the general practitioner, or family physician--the first to see the children with their ear problems--are urged to refer patients to an otologist when fluid is turbid. Development of tympanosclerosis must be prevented in the early but treatable stages. Prevention is less costly than repair.