Probabilities of Ossicular Discontinuity in Chronic Suppurative Otitis Media Using Pure-Tone Audiometry

2007 ◽  
Vol 28 (8) ◽  
pp. 1034-1037 ◽  
Author(s):  
Ryner Jose C. Carrillo ◽  
Nathaniel W. Yang ◽  
Generoso T. Abes
Keyword(s):  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media

scholarly journals Correlation of the Puretone Audiometry Findings with Intraoperative Findings in Patients with Chronic Suppurative Otitis Media

2015 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Devashri Uday Patil ◽  
Kiran S. Burse ◽  
Shreeya Kulkarni ◽  
Vandana Sancheti ◽  
Chaitanya Bharadwaj
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Number Of Patients ◽  
Operative Findings ◽  
Air Conduction

Chronic suppurative otitis media is one of the common otological conditions in India for which patients seek advice from an otorhinolaryngologist. Chronic suppurative otitis media is recurrent and progressive disease which is characterized with tympanic membrane perforation and suppurative discharge. Pure tone audiometry is the most common test used to evaluate auditory sensitivity. Since hearing loss is a common complication of chronic suppurative otitis media, we designed this study to evaluate preoperative pure tone audiometry findings in patients with chronic suppurative otitis media and its correlation with the intra-operative findings. <strong>Aims and Objectives:</strong> 1] To assess the intra-operative findings in patients with chronic suppurative otitis media. 2] To evaluate the correlation between the preoperative pure tone audiometry findings and intra-operative findings in patients with chronic suppurative otitis media. 3] To assess the type of hearing loss and degree of hearing loss in patients with chronic suppurative otitis media. <strong>Materials and Methods:</strong> This is an Observational study carried over a period of 3 years from August 2011 to August 2013. Total number of patients included in this study was 100. <strong>Result:</strong> Out of 100 patients studied 69 % of patients had Tubo-Tympanic type of CSOM, 31 % of patients had Attico-antral type of CSOM. In patients of Safe CSOM; Central perforation was seen in maximum cases 46.4 %, anterior central perforations was seen in 8.7 % cases, posterior central perforations seen in 20.2 % cases, and subtotal perforations seen in 24.63 % cases. In patients of Unsafe CSOM posterosuperior cholesteatoma was seen in maximum cases 67.74 %, and attic cholesteatoma was seen in 32.2 % cases. In safe CSOM patients all ossicles were intact and mobile whereas in unsafe CSOM patients only 4 patients had intact ossicular chain, while maximum patients had ossicular defect. <strong>Conclusion:</strong> Hearing loss depends on size of perforation. Hearing loss increases as the size of perforation increases. Average air conduction threshold and air bone gap did not differ significantly between various groups of ossicular defect. This shows us that neither air conduction nor air bone gap are reliable parameters on basis of which we can predict ossicular status preoperatively.

scholarly journals Relationship of Pure Tone Audiometry and Ossicular Discontinuity in Chronic Suppurative Otitis Media

2006 ◽  
Vol 21 (1-2) ◽  
pp. 5-10
Author(s):  
Ryner Jose C. Carrillo ◽  
Nathaniel W. Yang ◽  
Generoso T. Abes
Keyword(s):  
Logistic Regression ◽  
Otitis Media ◽  
Pure Tone ◽  
Operative Procedure ◽  
Multiple Logistic Regression Analysis ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Chronic Suppurative Otitis Media ◽  
Likelihood Ratios ◽  
Suppurative Otitis Media

Background: Pure tone audiometry is routinely used to determine conductive and sensorineural hearing status. Ossicular discontinuity is usually assessed intra-operatively. If ossicular discontinuity can be predicted by pure tone audiometry, perhaps the operative procedure of choice and prognosis for hearing can also be anticipated.   Objective: To determine the predictive value of preoperative pure tone audiometry on the presence of gross ossicular discontinuity in chronic otitis media.   Methods: Records of 205 patients, 7 to 75 years of age undergoing their first operation for chronic otitis media were reviewed. Preoperative audiograms and operative records for tympanomastoidectomy were evaluated. A total of 162 patients meeting inclusion criteria were included in the study. Likelihood ratios for positive and negative ossicular discontinuity for frequency-specific air-bone gap cut-offs were determined. Multiple logistic regression analysis for pure tone audiometry and operative findings to predict ossicular discontinuity was performed and a model for predicting ossicular discontinuity using logistic regression obtained.   Results and Conclusion: Frequency-specific air bone gap (ABG) cut-off values can predict ossicular discontinuity in chronic suppurative otitis media namely: < 20 dB ABG at 500 Hz predicts absence of ossicular discontinuity while > 50 dB ABG at 500 Hz, >30 dB ABG at 2 KHz, and > 50 dB ABG at 4 KHz best predict the presence of ossicular discontinuity in general. In the absence of cholesteatoma, the air bone gaps of <30 dB at 500 Hz and <20 dB at 1 KHz decrease probability of ossicular discontinuity from 32.97% to 2.54%. Combination of air bone gaps of >50 dB at 500 Hz, >20 dB at 2 KHz and >40 dB at 4 KHz increase the probability of ossicular discontinuity from 32.97% to 85.9%. These findings suggest that ossicular exploration may not be necessary for the former while an evaluation of the ossicular chain may be mandatory for the latter in the setting where cholesteatoma is not present or suspected.             Presence of cholesteatoma, granulation tissue and size of tympanic membrane perforation are important factors to consider in predicting ossicular discontinuity.   Keywords: air bone gap; audiometry, pure tone; ossicular discontinuity; otitis media, suppurative; logistic reg    

scholarly journals Correlation between degree of hearing loss and intraoperative findings in tubotympanic type of chronic suppurative otitis media

2018 ◽  
Vol 4 (2) ◽  
pp. 537 ◽  
Author(s):  
Ravi Dudda ◽  
Sowmya Tumkur Rangaiah ◽  
M. Hanumantha Prasad ◽  
Nagavara Kalegowda Balaji
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> The aim of tympanoplasty done for tubotympanic type of chronic suppurative otitis media (CSOM) should not only be to achieve a dry ear, but also to give hearing improvement to the patient. Aim of this study was to determine the correlation between size and site of tympanic membrane perforation with degree of hearing loss and correlation between ossicular chain status and degree of hearing loss on pure tone audiometry.</p><p class="abstract"><strong>Methods:</strong> Patients with tubotympanic CSOM with hearing loss upto 60 dBHL undergoing tympanoplasty were examined to know the site and size of tympanic membrane(TM) perforation. Intraoperative findings pertaining to middle ear and ossicles were noted.  </p><p class="abstract"><strong>Results:</strong> Out of 52 patients of tubotympanic type of CSOM, hearing loss was least (31.18±7.46 dBHL) in small perforations of the TM and highest in subtotal perforations (48.74±7.83 dBHL) which was statistically significant. Hearing loss was significantly more in posterior perforation (46.61±7.02 dBHL) than in anterior perforation of TM (32.65±8.77 dBHL).<strong> </strong>There was a statistically significant difference in pure tone average hearing loss between intact ossicle group (32.87±9.77 dBHL)<strong> </strong>and eroded ossicle group (43.39±9.60dBHL). Difference in air bone gap was also significant between intact ossicle group (24.09±9.56 dB) and eroded ossicle group (31.02±9.83 dB). Multiple ossicles were eroded in nineteen patients with incus being the most commonly eroded ossicle.</p><p><strong>Conclusions:</strong> In this study, hearing loss increased with increased size of TM perforation and also with posterior perforation. Incus was found to be the most commonly eroded ossicle. Multiple ossicles were seen eroded most commonly when hearing loss was moderate. The surgeon will be better equipped to do ossiculoplasty in view of these preoperative findings and also to counsel the patient better about their expectation of hearing improvement following surgery. </p>

scholarly journals Relation between the duration of disease and audiogram findings in tubotympanic type of chronic suppurative otitis media after myringoplasty

2020 ◽  
Vol 6 (12) ◽  
pp. 2202
Author(s):  
Rajamohan Ganganamoni ◽  
Saai Ram Thejas
Keyword(s):  
Developing Countries ◽  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Early Closure ◽  
History Of ◽  
One Year

<p><strong>Background:</strong> Chronic suppurative otitis media (CSOM) has been an important cause of hearing loss and ear discharge in people affected by it for a significant time now. Its prevalence is more in developing countries where the socioeconomic status is low. Poor and overcrowded living conditions, poor hygiene and nutrition have been suggested as a basis for the widespread prevalence of CSOM in developing countries. Pure tone audiometry is the easiest and the most basic procedure which needs to be performed on any patient who has history of hearing loss irrespective of the nature of the disease and the cause surrounding it. Every initial evaluation for CSOM should include audiometric testing via air and bone along with pure tone thresholds. Aim of the study was to co-relate the hearing loss to the duration of the disease in the ear in patients with CSOM and to also associate the same to the corresponding hearing changes after myringoplasty.</p><p><strong>Methods: </strong>Sixty patients were taken to be part of the study after following a strict inclusion and exclusion criteria. With proper consent, they underwent pure tone audiogram and myringoplasty. Their air bone (AC) gap and air conduction (AC) threshold results were tabulated with the duration of the disease and a consensus was reached at.</p><p><strong>Results: </strong>It was observed that the hearing loss was much lesser if the duration of the disease was lesser than one year.  As the diagnosis was delayed, both the AB gap and mean AC threshold went up. The early closure of the perforation can significantly bridge the AB gap but the same cannot be said about the AC threshold as it seemed to be lesser affected by the duration.</p><p><strong>Conclusions: </strong>It can thus be concluded that AC threshold is quietly independent of the changes in the diseased middle ear as compared to the AB gap. This makes it a stronger tool in the assessment of hearing. The early diagnosis and management of tubotympanic type of CSOM can not only help in preventing complications but also aid in better hearing protection which in-turn helps in better social survival.</p>

scholarly journals Comparative study between result of temporalis muscle fascia and tragal cartilage perichondrium as a graft material in type 1 tympanoplasty

2018 ◽  
Vol 4 (2) ◽  
pp. 565
Author(s):  
Abhay Kumar ◽  
Prabhu Narayan ◽  
Prem Narain ◽  
Jaypal Singh ◽  
Prateek Kumar Porwal ◽  
...  
Keyword(s):  
Otitis Media ◽  
Pure Tone Audiometry ◽  
Chronic Suppurative Otitis Media ◽  
Graft Material ◽  
Temporalis Fascia ◽  
Suppurative Otitis Media ◽  
Hearing Results ◽  
Group Type ◽  
Type 1 Tympanoplasty

<p class="abstract"><strong>Background:</strong> Leading cause of deafness in India is chronic suppurative otitis media. Most common cause of TM perforation is chronic suppurative otitis media. With this background this study was to compare hearing results, as well as graft takes for commonly preferred reconstruction techniques of the TM (i.e., temporalis fascia vs. cartilage) in tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> The present study consists of 60 cases of C.S.O.M (TTD) which was divided into two groups with 30 cases in each group. In first group type1 tympanoplasty was done by Temporalis fascia technique. In second group type 1 tympanoplasty done by tragal cartilage with perichondrium technique. History and otoscopic examination along with pure tone audiometry was performed preoperatively. Postoperative hearing results and graft uptake were compared between two groups, all surgeries were performed through the post aural approach.  </p><p class="abstract"><strong>Results:</strong> Graft uptake results are better with tragal cartilage with perichondrium technique. Hearing improved significantly in both groups. Though this was slightly better in TFT, but not significant statistically.</p><p><strong>Conclusions:</strong> Graft uptake rates are better with the tragal cartilage with perichondrium technique in comparison of TFT and hearing results are almost equivalent with both techniques.</p>

scholarly journals The intraoperative pathological findings in cases of chronic suppurative otitis media with central perforation of tympanic membrane at a tertiary care centre in Eastern Nepal

2017 ◽  
Vol 8 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Sanjeev Kumar Thakur ◽  
Nisha Ghimire ◽  
Rabin Acharya ◽  
Sanjay Kumar Singh ◽  
Anwar Afaque
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Tertiary Care ◽  
Pure Tone Audiometry ◽  
Chronic Suppurative Otitis Media ◽  
Pathological Findings ◽  
Tertiary Care Centre ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Central Perforation

Background: Chronic suppurative otitis media (CSOM) is the chronic inflammation of the middle ear cleft. The atticoantral type is called unsafe type because of the associated complications due to granulations and cholesteatoma which may be life-threatening. CSOM with central perforation (tubotympanic type) is usually not associated with major complications such as cholesteatoma formation.Aims and Objectives: To find out the intraoperative pathological findings in cases of CSOM with central perforation (tubotympanic type)Materials and Methods: This descriptive, cross sectional study has been conducted in the Department of Ear, Biratnagar Eye Hospital in Nepal over 2 years. Study group includes 172 patients having CSOM with central perforations in the tympanic membranes who underwent different types of procedures. Preoperatively, all the patients were evaluated with otoscopy, microscopy, pure-tone audiometry, and some patients with computed tomography scan. The pathological findings were confirmed with biopsy. The findings were tabulated and analysed.Results: 21(12.2%) patients were having dry central perforation with normal Eustachian tube function.  95 patients, i.e., 55.23% were having granulations in attic, aditus, antrum.  25 (14.53%) cases were having ossicular erosion.5 (2.9%) cases had tympanosclerosis in middle ear. 1 (0.58%) case had facial nerve dehiscence. 16 (9.3%) cases had oedema of middle ear mucosa/aural polyp from middle ear. Surprisingly 9 patients, i.e., 5.23% were having cholesteatoma which was confirmed by histopathological study.Conclusion: This study shows that cholesteatoma can be found in tubotympanic type of CSOM, along with other pathological findings. Hence it is on the part of the surgeon to be careful while planning surgery on their patients with CSOM (tubotympanic type), remembering that all safe CSOM might not always be safe. Asian Journal of Medical Sciences Vol.8(1) 2017 42-47

Correlation of Pure Tone Audiogram Results and Hearing Benefit of Tympanoplasty for Chronic Suppurative Otitis Media

2000 ◽  
Vol 109 (4) ◽  
pp. 381-384 ◽  
Author(s):  
Anthony Po Wing Yuen ◽  
Wai Kuen Ho ◽  
Yau Hui ◽  
William Ignace Wei ◽  
Dennis Kin Kwok Au
Keyword(s):  
Otitis Media ◽  
Pure Tone ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Pure Tone Audiogram

Tympanosclerosis: review of literature and incidence among patients with middle-ear infection

1999 ◽  
Vol 113 (12) ◽  
pp. 1076-1080 ◽  
Author(s):  
Saad Asiri ◽  
Alaa Hasham ◽  
Fatma Al Anazy ◽  
Siraj Zakzouk ◽  
Adel Banjar
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Clinical Picture ◽  
Pure Tone ◽  
Chronic Suppurative Otitis Media ◽  
Review Of Literature ◽  
Suppurative Otitis Media ◽  
Middle Ear Infection

AbstractThe aim of the study was to review the literature of tympanoscierosis especially its pathogenesis, to study the general incidence of tympanoscierosis among patients with chronic suppurative otitis media (CSOM), its association with cholesteatoma and also the type of hearing loss as well as its relation to the degree and site of tympanosclerosis.Seven hundred and seventy-five patients with CSOM were studied retrospectively. A full history was taken and thorough ENT examinations were carried out. Pure tone audiograms (PTA) of all patients were done and analysed. The operative finding of tympanosclerosis as well as middle-ear status were inspected.The incidence of tympanosclerosis was found to be 11.6 per cent (90 patients out of 775 CSOM cases). Most tympanosclerosis cases had dry ear, (85.6 per cent). Of the 57.8 per cent who had myringosclerosis, their PTA showed an AB gap 20–40 dB. When sclerosis affect both the tympanic membrane and middle ear, 61 per cent of patients had an AB gap >40 dB. The association of cholesteatoma and tympanosclerosis may be regarded as uncommon, 2.2 per cent.The exact aetiology and pathogenesis of tympanosclerosis is as yet not well known. Our study concentrated on the clinical picture of tympanosclerosis among patients with CSOM. The majority of hearing loss associated with tympanosclerosis was of the conductive type.

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