title: Granular myringitis: Incidence and clinical characteristics.
abstract: OBJECTIVE
  To examine the incidence and the clinical features of granular myringitis (GM).
  
  
  METHODS
  A 2-year prospective cohort study.
  
  
  METHODS
  A primary otolaryngology clinic affiliated with a tertiary academic referral center.
  
  
  METHODS
  All-aged patients diagnosed with GM who had no apparent middle ear disease or did not undergo ear surgery.
  
  
  METHODS
  Otoscopy and bacteriologic and histopathologic studies.
  
  
  METHODS
  Granular myringitis was noted in 0.41% of patient's population presenting different forms.
  
  
  RESULTS
  Granular myringitis was detected in 26 patients. Recurrent infection occurred in seven (26.9%) and bilateral GM in five patients (19.2%). Perforation of the tympanic membrane (TM) was noted in eight patients (30.7%), six of which closed spontaneously. Otoscopic findings could be classified into three grades: focal de-epithelization (in 10), focal polypoid granulations (in 13), and diffuse polypoid formation over the entire TM (in 3). Histopathologic examination disclosed tiny fragments of granulation tissue infiltrated by nonspecific chronic and acute inflammatory reaction.
  
  
  CONCLUSIONS
  Granular myringitis is encountered not infrequently in primary otolaryngology practice and presented different forms, recurrent episodes, and bilateral involvement. Topical application of antibiotics or caustic agents was successful in all cases. Perforation of the TM may develop and resolve spontaneously during the course of the disease.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, The Chaim Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. wolfm@post.tau.ac.il
authors.forename: Michael
authors.initials: M
authors.lastname: Wolf
authors.forename: Adi
authors.initials: A
authors.lastname: Primov-Fever
authors.forename: Iris
authors.initials: I
authors.lastname: Barshack
authors.forename: Silvi
authors.initials: S
authors.lastname: Polack-Charcon
authors.forename: Jona
authors.initials: J
authors.lastname: Kronenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006097:Granulation Tissue / Q000473:pathology*; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010032:Otitis Externa / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D011446:Prospective Studies; D012008:Recurrence; D014432:Tympanic Membrane / Q000473:pathology*