Granular myringitis in children

Background: Granular myringitis (GM), described mainly in adults, is consid ered a rare infection of the tympanic membrane (TM) with possible involveme nt of the external ear canal. The study was aimed to evaluate the clinical characteristics of the disease in children. Material: A 2-year prospective study on all children with GM in a primary otolaryngology practice affiliat ed to a tertiary academic medical center. GM was defined by de-epithelizati on of the TM, granulation-tissue formation and discharge. Children with oti tis: media were excluded. Treatment included topical application of ear dro ps, caustic solution in unresponsive cases and mechanical removal of polypo idal granulations. Results: Nine children, five boys and four girls, aged 3 -16 (mean = 11.5 years) were diagnosed as GM. Mainly plugged ear (6) and au ral discharge (5) presented GM. Only a circumscribed area of the pars tensa was involved. GM was expressed either by a tiny shallow lesion (6) or by r aised polypoidal masses (3). All children recovered within 2-11 weeks (mean 3.6). Recurrent infection was noted twice in one child. Small dry perforat ion of the TM was noted in two children. Histopathological studies revealed non specific acute and chronic inflammatory reaction. Conclusions: Granula r myringitis must be recognized in children. GM has a benign course respond ing to topical treatment. It may be misidentified as persistent chronic sup purative otitis media with polyps protruding through the TM. Although perfo ration of the TM may develop in the course of the disease, the middle ear r emained intact. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.