scholarly journals Ossicular chain status in cases of cholesteatomatous chronic otitis media in eastern Nepal

2017 ◽  
Vol 8 (3) ◽  
pp. 68-71
Author(s):  
Sanjeev Kumar Thakur ◽  
Nisha Ghimire ◽  
Rabin Acharya ◽  
Sanjay Singh ◽  
Afaque Anwar
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
The Status ◽  
Chief Complaints ◽  
Age Range

Background: Ossicular erosion and disruption of ossicular chain is a frequent complication of cholesteatomatous chronic otitis media leading to hearing loss.Aims and Objectives: To find out the status of ossicles and ossicular chain in patients of choleasteatomatous chronic otitis media undergoing surgery.Materials and Methods: This is a descriptive, cross sectional study conducted among 52 patients of chronic suppurative otitis media with cholesteatoma undergoing surgery at Biratnagar Eye Hospital, Ear Department over 3 years. In each patient the condition and the integrity of ossicular chain was evaluated in order to determine the presence and site of lesion of each ossicles. The data was analysed and expressed in numbers and percentage.Results: Among 52 cases, 27(51.92%) were male and 25(48.08%) were female. The age range was 16 to 50 years. The mean age was 25.6 years. The commonest age range was of 16-20 years, 21 (40.38%). The chief complaints of the patients were ear discharge seen in 52 (100%) cases and hearing loss in 45 (86.5%) cases. Malleus was found intact in 37 (71.1%) cases and absent in 7(13.5%). Handle erosion was found in 3(5.8%) cases. Head and handle erosion was found in 5(9.6%) cases. Incus was found intact in only 6 (11.5%) cases and absent in 11 (21.2%) cases. Long and lenticular process was eroded in 35(67.3%) cases. Intact suprastructure of Stapes was found in 27(51.92%) cases. Suprastructure erosion was found in 25(48.08%) cases. Intact ossicular chain was found only in 6(11.5%) cases. M+S+ was found in 17(32.7%) cases followed by M+S- in 14(26.9%). M-S+ was found in 4(7.8%) cases. All the ossicles eroded were found in 11(21.1%) cases.Conclusion: In this study of cholesteatomatous ears, the Malleus was found to be the most resistant ossicle to erosion, whereas, Incus was found to be the most susceptible. Asian Journal of Medical Sciences Vol.8(3) 2017 68-71

scholarly journals Role of pure tone audiometry in assessing ossicular status in patients with mucosal type of chronic otitis media

2020 ◽  
Vol 6 (5) ◽  
pp. 853
Author(s):  
Deepthy Das ◽  
Gurumani Sriraman ◽  
Valli Rajasekaran
Keyword(s):  
Otitis Media ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is the disease of the middle ear cleft, which presents as hearing loss and ear discharge. This study aimed to assess the role of pure tone audiometry (PTA) in analysing the ossicular erosion in mucosal type of CSOM subjects.</p><p class="abstract"><strong>Methods:</strong> The current cross-sectional study was conducted among 60 people with mucosal CSOM.  Preoperative hearing was assessed by PTA. The surgeries were done and intra operative ossicular status were recorded. IBM SPSS 20 software was used for the analysis. Student t-test was used to correlate ossicular status and PTA findings.  </p><p class="abstract"><strong>Results:</strong> Among 60 subjects, 12 (20%) patients had eroded incus and 53 (88.3%) had normal stapes. The malleus was preserved in all patients. The result of our study showed that an average ABG of 58 dB at 500 Hz, 47 dB at 1 kHz, 41 dB at 2 kHz and 41 dB at 4 kHz in patients with   ossicular erosion. ABG for 500 Hz and 1 kHz were statistically significant for eroded incus. ABG for 500 Hz, 1 kHz, 2 kHz and 4 kHz were all statistically significant for eroded stapes.</p><p class="abstract"><strong>Conclusions:</strong> There is a significant difference between the PTA findings at different frequencies between intact and eroded ossicular chain. Pre-operative ABG helps us to assess the status of incus and stapes.</p>

scholarly journals Pre-operative predictors of ossicular necrosis in chronic otitis media-mucosal type

2019 ◽  
Vol 5 (2) ◽  
pp. 396
Author(s):  
Razim Abdul Rasheed ◽  
Mubeena . ◽  
K. S. Gangadhara Somayaji
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Bivariate Analysis ◽  
Middle Ear Mucosa ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Wide Range

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media can cause a wide range of pathologies in the middle ear that include irreversible mucosal changes, granulation tissue formation, cholesteatoma, tympanosclerosis, and destruction of ossicles. Knowledge regarding ossicular discontinuity before surgery enables the surgeon to be prepared for ossiculoplasty. Objective was to study the pre-operative clinical, audiological and microscopic findings in chronic otitis media mucosal type and correlate preoperative findings with intra-operative ossicular necrosis. </p><p class="abstract"><strong>Methods:</strong> Study design was observational, descriptive and cross sectional study. All patients were subjected to detailed clinical, otoscopic and microscopic examination to assess the size and site of perforation, presence or absence of ear discharge, granulation tissue, tympanosclerosis in the middle ear, exposure of incudostapedeal joint and condition of middle ear mucosa. Pure tone audiogram was also done. All patients underwent tympanoplasty±cortical mastoidectomy and the intraoperative findings of ossicular necrosis were noted.  </p><p class="abstract"><strong>Results:</strong> Of the 105 patients, 18(17.1%) had ossicular necrosis. Bivariate analysis showed positive correlation for long standing disease (p=0.004), presence of discharging ear (p=0.014), polypoidal middle ear mucosa (p=0.000) granulations in middle ear (p=0.000) and also when incudostapedeal joint was exposed (p=0.005). Mean Air bone gap was higher with 35 dB in ossicular necrosis and 22.7 dB in intact ossicular chain was also statistically significant (p=0.0001).</p><p class="abstract"><strong>Conclusions:</strong> Ossicular necrosis was best indicated by the presence of polypoidal mucosa, granulation in the middle ear and higher air-bone gap on audiometry. However longer duration of disease, persistent active stage of disease and exposure of incudostapedeal joint were also found to be significant.</p>

scholarly journals Evaluation of single stage tympanomastoid surgery in unsafe chronic suppurative otitis media in Kashmiri population: a cross sectional study

2020 ◽  
Vol 6 (5) ◽  
pp. 939
Author(s):  
Parvez Ahmed Mir ◽  
Owais Makhdoomi ◽  
Syed Waseem Abbas
Keyword(s):  
Otitis Media ◽  
Ossicular Chain ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Single Stage ◽  
Chronic Suppurative Otitis Media ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Ossicular Chain Reconstruction ◽  
Operative Findings

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is typically a persistent disease insidious in ONSET, affecting the mucoperiosteal lining of middle ear cleft, often capable of causing severe destruction and irreversible sequelae and manifests clinically with hearing impairment and discharge. Successful management of unsafe CSOM has posed challenge before otolaryngologists for ages.</p><p class="abstract"><strong>Methods:</strong> The prospective study is based on 40 patients of unsafe CSOM who were managed and followed up in the post graduate department of otorhinolaryngology and head and neck surgery of Government medical college Srinagar with relevant data was recorded on the proforma.  </p><p class="abstract"><strong>Results:</strong> All the patients who underwent single stage tympanomastoid surgery with or without ossicular chain reconstruction had no evidence of recurrent disease at follow up with 82.5% were below the age of 40, of which 40% were between 21 to 30 years. Males were more involved than females (1.2:1), also CT scan findings were co related with intra operative findings during our study.</p><p class="abstract"><strong>Conclusions:</strong> In conclusion a perfectly performed canal wall down mastoidectomy with tympanoplasty with us without ossiculoplasty in same sitting give good and acceptable post-operative results as far as the hearing improvement and dry and safe ear is concerned.</p>

Preoperative Predictors in Chronic Suppurative Otitis Media for Ossicular Chain Discontinuity: A Cross-Sectional Study

2016 ◽  
Vol 21 (4) ◽  
pp. 231-236 ◽  
Author(s):  
Rashid Sheikh ◽  
Hassan Haidar ◽  
Hassanin Abdulkarim ◽  
Waqar Aslam ◽  
Aisha Larem ◽  
...  
Keyword(s):  
Otitis Media ◽  
Ossicular Chain ◽  
Cross Sectional Study ◽  
Chronic Suppurative Otitis Media ◽  
Sectional Study ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Cutoff Values ◽  
Degree Of Certainty ◽  
Preoperative Predictors

Objective: Ossicular discontinuity may result from chronic suppurative otitis media and is usually detected intraoperatively. Our objective is to determine whether a preoperative audiogram can preoperatively predict the presence or absence of ossicular discontinuity. Methods: A cross-sectional study was prospectively run on our patients, aged 12-75 years, ultimately operated on for chronic suppurative otitis media. Preoperative audiograms were analyzed to measure frequency-specific air-bone gap (ABG) cutoff values. Intraoperatively, ossicular chain integrity was carefully checked. Logistic regression analysis was done to obtain a predictive model. Results: A total of 270 patients (306 ears) were included. Frequency-specific ABG cutoff values can predict ossicular discontinuity, namely: high ABGs at 1,000 Hz (>27.5 dB) and 2,000 Hz (>17.5 dB) are the most reliable variables associated with ossicular discontinuity. Conclusion: Preoperative audiograms can predict the presence of ossicular discontinuity in chronic suppurative otitis media. Large ABGs at both 1,000 and 2,000 Hz can predict ossicular discontinuity with a great degree of certainty.

scholarly journals Evaluation of hearing status after type I tympanoplasty

2020 ◽  
Vol 24 (1) ◽  
pp. 50-55
Author(s):  
Mashuque Mahamud ◽  
Mani Lal Aich ◽  
Abdullah Al Mamun ◽  
Rafiul Alam
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Type I ◽  
Cross Sectional ◽  
Female Ratio ◽  
The Mean ◽  
Type I Tympanoplasty ◽  
Air Conduction

Objective: To evaluate hearing outcome after type I tympanoplasty in inactive mucous type of chronic otitis media. Methods: It was a cross-sectional study conducted in the department of Otolaryngology & Head Neck Surgery, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from July 2014 to June 2016. 50 cases were selected by matching inclusion and exclusion criteria. Paired t-test and Z test was used to analyze the variables. P values <0.05 was considered as statistically significant. Results: The mean age was found 28.5 years with range from 15 to 41 years and male female ratio was 1.3:1. All patients had intermittent otorrhoea and varying degree of hearing loss. The mean air conduction threshold was 40.2 dB preoperatively and 27.1 dB post-operatively. Air-bone gap was found 26.9 dB in preoperative and 16.1 dB in post-operative group. The differences were statistically significant between preoperative and post-operative group. Thus mean improvement of air conduction threshold was 13.1 dB and air-bone gap was 10.8 dB. Two third (66.%) patients improved <15 db air conduction thresholds and 17(34%) improved ≥15 db air conduction thresholds. Using the proportion of patients with a postoperative hearing within 40 dB as the criterion, this study showed 46(92%) patients achieving this and 40(80%) patients achieving AB gap within 20 db postoperatively. Conclusion: Improvement of air conduction threshold and AB gap after type I tympanoplasty was statistically significant. Thus from this study it can be concluded that type I tympanoplasty is an effective technique for hearing improvement in inactive mucous type of chronic otitis media. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 50-55

scholarly journals Scanning Electron Microscopy in the Evaluation of Defects to the Ossicular Chain in the Course of Chronic Otitis Media

2019 ◽  
pp. 014556131987391
Author(s):  
Agnieszka Wiatr ◽  
Katarzyna Swiezy ◽  
Jacek Skladzien ◽  
Maciej Wiatr
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Chronic Inflammation ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Suppurative Otitis Media ◽  
Ear Ossicles ◽  
Scanning Electron

Objective: Chronic otitis media is a heterogeneous disorder. Chronic suppurative otitis media with cholesteatoma and, to a lesser extent, chronic otitis media with granulation lead to the destruction of bone structures within the middle ear. Bone loss may appear in the prominence of the horizontal semicircular canals and the bony canal of the facial nerve. The inflammatory process may spread to the bony labyrinth of the sigmoidal sinuses and the cranial cavities. Materials and Methods: The analysis comprised the examination of fragments of auditory ossicles removed during surgery in 21 patients with various types of chronic inflammation of the middle ear. The purpose of this study was to evaluate the usefulness of scanning electron microscopy in evaluating the erosion of middle ear ossicles in different types of chronic otitis media. Images captured at various magnifications were used for the best possible illustration of the observed lesions in bone tissue. Results: The observed lesions and the degree of bone surface damage were dependent on the type of chronic inflammation of the middle ear. The largest destructive changes in the ossicular chain were observed in chronic otitis media with cholesteatoma; smaller changes were observed in chronic otitis media with granulation. Conclusion: In the case of damage to the ossicles inflicted by inflammation, the use of a modeled bone block made of a temporal bone taken from outside the tympanic cavity or a biomaterial prosthesis is a good choice in ossiculoplasty.

scholarly journals Improvement of Tinnitus following Tympanoplasty and Tympanomastoidectomy Surgeries in Patients with Chronic Otitis Media

2016 ◽  
Vol 5 (2) ◽  
pp. 63-69
Author(s):  
Masoumeh Saeedi ◽  
Mohammad Hossein Khosravi
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Cross Sectional Study ◽  
Common Symptom ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Tinnitus Severity ◽  
Spss Software

Background: After otorrhea and hearing loss, Tinnitus is the most common symptom in pa­tients with chronic otitis media (COM). The aim of this study was to evaluate the improvement of tinnitus in COM patients after tympanoplasty and tympanomastoidectomy surgeries. Mate­rials and Methods: This cross-sectional study was conducted on COM patients suffering from Tinnitus referred to Baqiyatallah hospital, Tehran, Iran undergoing tympanoplasty or tympano­mastoidectomy surgeries between March 2013 and August 2014. Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) questionnaires were filled before and two months after surgery by each patient, and considered subjects were compared with each other. Audiometry test was taken from each patient before and two months after surgery. Audiometry results as well as Air-Bone gap were measured and evaluated prior and after surgery. Data were analyzed using SPSS software by ANOVA, sample t-test and Chi-square tests. Results: Eventually, 26 male and 24 female patients with a mean age of 38.62±11.88 years were enrolled. Air conduc­tion at all frequencies was 49.99±17.37 before and 36.98±22.06 after surgery (P<0.001). Sever­ity of tinnitus was 62.92±30.54 before and 30.54±20.08 after surgery based on THI (P<0.001). Also, it was 7.46±1.66 before and 3.5±2.06 after surgery based on VAS evaluations (P<0.001). Tinnitus severity reduction was significantly associated with the improvement of hearing loss and decrement of air-Bone gap (P<0.001). Tinnitus symptoms such as loudness, annoyance, impact on life and perception of Tinnitus significantly reduced after surgery. Moreover, Tym­panomastoidectomy was more effective on the improvement of Tinnitus in comparison with Tympanoplasty (P=0.019).Conclusion: It seems that, both tympanomastoidectomy and tympa­noplasty surgeries are effective on the improvement of tinnitus in patients with COM; however, Tympanomastoidectom surgery was shown to be more effective.[GMJ.2016;5(2):63-69]

scholarly journals Study of Antibiotic Sensitivity of Aural Swab and Aetiological Factors of Chronic Otitis Media-Active Mucosal Type

2021 ◽  
Vol 27 (2) ◽  
pp. 111-116
Author(s):  
Md Nesar Uddin ◽  
Mohammed Sirazul Islam ◽  
Mohammad Delwar Hossen ◽  
Mohammed Iftekharul Alam ◽  
Mohammad Kamal Hossain
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Cross Sectional ◽  
Data Collection Sheet ◽  
One Year ◽  
Head Neck ◽  
Middle Ear Cleft

Background: Chronic otitis media (COM) refers to chronic inflammation of mucoperiosteal lining of middle ear cleft resulting in aural discharge and deafness. The objective of this study is to evaluate the antibiotic sensitivity and aetiological factors of COM. Methods: This cross-sectional study was conducted from July 2017 to June 2018 for duration of one year among the patients who attended with COM- active mucosal disease at Department of ENT & Head Neck Surgry, Combined Military Hospital (CMH) Chattogram. Total 50 cases were isolated and among them 5 cases had been suffering from bilateral COM. Aural swab was taken from 55 ears and a predesigned data collection sheet was duly filled up with the information of socioeconomic status of the patient. The laboratory records of every case was systematically organized. The data were analyzed with simple manual analysis using percentage and frequency. Results: About 24% patients were in 31-40 years age group. Out of 50 patients 62% were male. 44% patient lived in barrack. Ear cleaning habit shows, 32% has got the cleaning habit with cloth and stick. Out of 50 patients 5 had bilateral COM. So out of 55 ears, Culture & sensitivity test viewed that Pseudomonas aeruginosa was the most predominant organism - 41.8% followed by S. aureus- 30.9% Antibiotic sensitivity profile shows, 80% cases showing sensitivity to Amikacin then gentamycin-73.3% Resistant 5 cases showed 100% sensitivity to Tazobactum. Again out of 19 cases of Gram positive organism 78.9% were sensitive to Amoxyclav. 3 resistant cases showed 100% sensitivity to Meropenem. Conclusion: By studying this topic we hope to able to make an idea about the aetiological and predisposing factors and antibiotic sensitivity of COM-active mucosal variety. Bangladesh J Otorhinolaryngol 2021; 27(2): 111-116

scholarly journals Relationship of Preoperative Hearing loss with Peroperative Ossicular Discontinuity in Chronic Otitis Media

2020 ◽  
Vol 25 (2) ◽  
pp. 94-101
Author(s):  
Nibash Chandra Ghosh ◽  
Kanu Lal Saha ◽  
Nasima Akhtar ◽  
Md Manjurul Islam ◽  
Arif Mahmud Jewel ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Neck Surgery ◽  
P Value ◽  
Common Disease ◽  
Moderate Degree ◽  
Cross Sectional ◽  
Severe Degree

Background: Chronic Otitis Media (COM) is a common disease in our country. COM with or without cholesteatoma may lead to ossicular discontinuity. However, the discontinuity of the ossicular chain is usually confirmed during operation. The purpose of the study was to find out the correlation between preoperative hearing loss and the status of ossicular chain at surgery. Methods: This cross-sectional study was conducted in the department of otolaryngology- Head & neck surgery, Bangabandhu Sheikh Mujib Medical University from January 2013 to June 2014. At least 113 patients of COM were selected as per inclusion and exclusion criteria. Relevant data were collected in a predesigned data collection sheet and analyzed with standard statistical method. Statistically significant inferred for P value <0.05. No groups whose ability to give voluntary informed consent questionable was not included. No potential risks exist in designed this study. Results: Out of 34 patients with mild degree of hearing loss 31(39.7%) had intact ossicular chain whereas discontinuity was seen in 3(8.6%) cases, 37 patients with moderate degree of hearing loss 16(45.7%) had ossicular discontinuity. Among 23 patients with moderate to severe degree of hearing loss 14(17.9%) had intact ossicular chain whereas ossicular discontinuity was found 9(25.7%), 9 patients of severe degree of hearing loss 7(20%) had ossicular discontinuity. Cases with moderate and severe degree of hearing loss had significant ossicular discontinuity (p<0.05). Air-bone gap > 40 dB was found in 60% cases of ossicular discontinuity, followed by air bone gap 31-40 dB(17.14%), 21-30 dB(14.29%) and 11-20 dB( 8.57%) respectively. So ossicular discontinuity was in higher air-bone gap group and it was statistically significant (p<0.001). Bangladesh J Otorhinolaryngol; October 2019; 25(2): 94-101

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