CORRELATION OF OSSICULAR CHAIN DEFECTS WITH AUDIOMETRIC PROFILE IN PATIENTS WITH CHRONIC SUPPURATIVE OTITIS MEDIA SQUAMOUS EPITHELIAL TYPE

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. Aims and Objectives: 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. Materials and Methods: 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. Result: 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. Conclusion: 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.

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Radio-surgical correlation of chronic suppurative otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195700 ◽

2019 ◽

Vol 6 (1) ◽

pp. 118

Author(s):

Yogeesha B. S. ◽

Nagaraj Maradi ◽

Ravi Shekhar ◽

Rohini D. Urs

Keyword(s):

Otitis Media ◽

Middle Ear ◽

Predictive Value ◽

Ossicular Chain ◽

Chronic Suppurative Otitis Media ◽

High Resolution Computed Tomography ◽

Suppurative Otitis Media ◽

Fallopian Canal ◽

Ear Ossicles ◽

Kappa Value

Background: Chronic suppurative otitis media (CSOM) because of disease nature and location of vital structures like middle ear ossicles, facial nerve, and lateral semicircular canal poses clinical as well as radiological challenge in diagnosis, especially the squamosal variety. Hence this study to evaluate radio-surgical correlation in cases of CSOM.Methods: We retrospectively analysed 92 case records who met the inclusion criteria. Their pre-operative high-resolution computed tomography (HRCT) temporal bone imaging was evaluated for erosion of the ossicular chain and the fallopian canal. This was correlated with the surgical findings noted intra-operatively. The appropriate statistical analysis was carried out. The radio-surgical correlation was evaluated by Cohen’s kappa value. Results: The kappa value for status of ossicular chain was 0.805 and 0.384 for status of fallopian canal. HRCT imaging had a positive predictive value and negative predictive value of 94.3% and 85.3% respectively, in detecting ossicular chain erosion. In detecting fallopian canal erosion, HRCT showed a sensitivity of 33.3%. Analysing the individual ossicles, we found kappa to be 0.266 for malleus, 0.463 for incus and 0.827 for stapes.Conclusions: There was excellent radio-surgical correlation for ossicular chain erosion while it was poor for fallopian canal erosion. HRCT showed excellent radio-surgical correlation for stapes, moderate for incus and poor for malleus. In-spite of its shortcomings in differentiating cholesteatoma and non-cholesteatomatous pathologies of the middle ear cleft, HRCT imaging plays a key role in assessing the status of the ossicles and fallopian canal.

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Ossicular Chain Erosion in Chronic Suppurative Otitis Media

otolaryngology ◽

10.4172/2161-119x.1000203 ◽

2015 ◽

Vol 05 (04) ◽

Cited By ~ 1

Author(s):

Hassan Haidar Rashid Sheikh

Keyword(s):

Otitis Media ◽

Ossicular Chain ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media

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The value of CT scanning in chronic suppurative otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215100118031 ◽

1991 ◽

Vol 105 (12) ◽

pp. 990-994 ◽

Cited By ~ 35

Author(s):

B. J. O'Reilly ◽

E. B. Chevretton ◽

I. Wylie ◽

C. Thakkar ◽

P. Butler ◽

...

Keyword(s):

Otitis Media ◽

Bone Erosion ◽

Ct Scanning ◽

Ossicular Chain ◽

Chronic Suppurative Otitis Media ◽

Facial Canal ◽

High Definition ◽

Suppurative Otitis Media ◽

Small Areas ◽

Lateral Canal

AbstractHigh definition CT has been advocated for the evaluation of chronic suppurative otitis media (CSOM) either generally or in selected cases. It is said to be capable of producing the fine detail needed to detect lateral canal fistulae, exposed dura and facial canal dehiscences, and to demonstrate the ossicular chain. At present there is no agreement on either the indications for CT scanning in CSOM or the most appropriate scanning plane. To determine the value of high definition CT in CSOM and to decide a unit policy for its application, 36 cases of CSOM underwent pre-operative CT scanning and their scans were compared with the operative findings.Our results show CT to be highly sensitive to the presence of soft tissue disease and bone erosion, moderately sensitive to the presence of lateral canal fistulae but less sensitive to the presence of small areas of exposed dura, ossicular continuity and facial canal dehiscence. Axial scans were better able to demonstrate the lateral canal but otherwise coronal scans were superior; ideally patients should be scanned in both planes. The principle value of CT in CSOM is its ability to demonstrate disease which is not clinically apparent.

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OSSICULAR CHAIN STATUS IN CHRONIC SUPPURATIVE OTITIS MEDIA SAFE TYPE UNDERGOING TYMPANOPLASTY

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2018/747 ◽

2018 ◽

Vol 5 (53) ◽

pp. 3668-3671

Author(s):

Budh Ram Singh ◽

Anup Agrawal ◽

Vidya Bhusan Sahu ◽

Arti Pandey

Keyword(s):

Otitis Media ◽

Ossicular Chain ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180717 ◽

2018 ◽

Vol 4 (2) ◽

pp. 537 ◽

Cited By ~ 1

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

Background: 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.Methods: 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. Results: 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). There was a statistically significant difference in pure tone average hearing loss between intact ossicle group (32.87±9.77 dBHL) 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.Conclusions: 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.

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Does The Type of Ossicular Chain Lesion Affect Outcomes in Chronic Suppurative Otitis Media Without Cholesteatoma?

The Journal of International Advanced Otology ◽

10.5152/iao.2019.5554 ◽

2019 ◽

Vol 15 (1) ◽

pp. 28-33

Author(s):

Tamas Horvath ◽

◽

Dora Lukacs ◽

Barnabas Horvath ◽

Tamas Ferenci ◽

...

Keyword(s):

Otitis Media ◽

Ossicular Chain ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media

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Intraoperative Findings during Canal Wall Down Mastoidectomy in Children

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v31i3.5357 ◽

1970 ◽

Vol 31 (3) ◽

pp. 184-187

Author(s):

S Shrestha ◽

P Kafle

Keyword(s):

Otitis Media ◽

Ossicular Chain ◽

Chain Condition ◽

Chronic Suppurative Otitis Media ◽

Canal Wall ◽

Suppurative Otitis Media ◽

Bony Landmarks ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Operative Findings

Objective: The main objective of this study is to assess the intraoperative finding during canal wall down mastoidectomy in paediatric patients undergoing surgery for unsafe type of chronic suppurative otitis media (CSOM) attending ENT OPD of Kathmandu Medical College. Materials and Methods: Fifty patients of age group 4 to 13 years who were suffering from unsafe type of CSOM with or without cholesteatoma were taken for the study. The study period was two years from April 2007 to March 2009. The operative findings like extent of cholesteatoma in different location of middle ear cleft, mastoid bony landmarks, and ossicular chain condition and otogenic complication were identified during canal wall down mastoidectomy. Result: Of the 50 patients 32 (64%) were boys and 18(36%) were girls. The age ranged from 4 years to 13 years. Majority of patients had cholesteatoma with granulation diseases (72%) followed by granulation diseases (16%). Involvement of disease in attic, aditus, antrum and mesotympanum were found to be high in majority of cases (82%) with high percentage of necrosis of incus (56%). Conclusion: The primary disease found in patients undergoing canal wall down mastoidectomy (CWDM) was cholesteatoma combined with granulation in72%, granulation in 16% and cholesteatoma in12%. Key words: Canal Wall Down; ENT; Mastoidectomy; Chronic Suppurative Otitis Media (CSOM) DOI: http://dx.doi.org/10.3126/jnps.v31i3.5357 J Nep Paedtr Soc 2011;31(3):184-187

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