Granular myringitis: Incidence and clinical characteristics.

OBJECTIVE

To examine the incidence and the clinical features of granular myringitis (GM).

STUDY DESIGN

A 2-year prospective cohort study.

SETTING

A primary otolaryngology clinic affiliated with a tertiary academic referral center.

PATIENTS

All-aged patients diagnosed with GM who had no apparent middle ear disease or did not undergo ear surgery.

INTERVENTION

Otoscopy and bacteriologic and histopathologic studies.

MAIN OUTCOME MEASURES

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.

CONCLUSION

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.