Chronic myringitis: prevalence, presentation, and natural history.
OBJECTIVE
The aim of this study was to examine the clinical presentation and natural history of chronic myringitis (CM).


METHODS
Retrospective case review.


METHODS
Tertiary referral center.


METHODS
Chronic myringitis is defined as a loss of tympanic membrane epithelium for >1 month without disease within the tympanic cavity. Seven hundred fifty patient records were reviewed to determine the prevalence of CM in an academic otology practice. The records of 40 patients (45 ears) with CM seen between 1995 and 1999 inclusive were reviewed.


METHODS
The series was reviewed with attention to previous medical and otologic history, the nature and duration of symptoms, the physical findings, and management.


RESULTS
The prevalence of CM was found to be -1% (approximately one fourth as common as cholesteatoma). Symptoms were often present for many years before the diagnosis of CM, with CM often mistaken for chronic otitis media. Sixty percent of patients had undergone previous otologic procedures. There did not appear to be an association between CM and systemic disease. Physical findings were varied, with granulation tissue and tympanic membrane perforations often occurring transiently. The clinical course of CM is typified by recurrent episodes of symptoms, often interspersed with long asymptomatic periods. A subset of CM can result in an acquired atresia. The most effective treatment appeared to be prolonged topical medications, surgery being reserved for only the most refractory cases.


CONCLUSIONS
Chronic myringitis is often mistaken for chronic otitis media. Such confusion prolongs the initiation of appropriate management and sometimes leads to needless tympanomastoid surgery. The otologist should be aware of this clinical entity and its varied presentation.
Blevins
N H
NH
Department of Otolaryngology/Head  Neck Surgery, Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts, USA.
Karmody
C S
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000382:microbiology / Q000628:therapy; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis / Q000628:therapy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004427:Ear Diseases / Q000175:diagnosis* / Q000382:microbiology* / Q000628:therapy; D004848:Epithelium / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010033:Otitis Media / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014432:Tympanic Membrane / Q000000981:diagnostic imaging* / Q000382:microbiology*