Evaluation of the relashionship between clinical findings before tympanoplasty and ossicular discontinuity and erosion in patients with chronic otitis media
Journal of Otorhinolaryngology and Facial Plastic Surgery,
Vol. 3 No. 1 (2017),
16 August 2017
Background: Chronic Otitis Media (COM) is a relatively common condition and the occurrence of hearing loss is probable. COM may lead to ossicular discontinuity, and unless the operation is performed, it won't be determined. Identifying possible cases of erosion and discontinuity of ossicles is helpful in surgical planning and in anticipation of the probable need for procuring ossicular prosthesis.
Purpose: The aim of this study was to evaluate the relationship between preoperative clinical findings and intraoperative findings.
Methods: This is a cross sectional study carried out in 2012 in two tertiary referral hospitals of Tehran, (the Loghman and the Taleghani hospitals). The sample under study consisted of COM patients who referred to the otolaryngology clinics and were tymponoplasty candidates. Two hundred and seven patients with the mean age of 36.2±13.9 (ranging from 9-67 years) were enrolled in the study. Pre-surgical findings were investigated and the relationship between ossicular discontinuity and pre-surgical findings were evaluated.
Results: Incus-Stapes discontinuity (IS Discontinuity) and Incus-Malleus discontinuity (IM Discontinuity) were seen in 60 (29%) and 25 (12.1%) patients, respectively. We found IS Discontinuity in 38 (24.1%) patients with central perforation and 22 (48.9%) cases of marginal perforations (P=0.005). IM Discontinuity was observed in 14 (8.9%) cases with central perforation, while this was seen in 11 (22.4%) cases with marginal perforations (P=0.011). On the other hand, 34 (42%) patients with otorrhea had IS Discontinuity whereas 26 (20.6%) cases of dry ears showed this type of ossicular problem (P<0.001). IM Discontinuity was detected in 13 (16%) and 12 (9.5%) cases with and without otorrhea, respectively (P=0.011). IS Discontinuity and IM Discontinuity were significantly more common in the patients with Air Bone Gap of more than 40 db.Conclusion: Our finding showed that surgical results may be unpleasant in the patients with marginal perforation, otorrhea and ABG>40 db.
- Ossicular discontinuity
- Tympanic membrane
How to Cite
. Vikram BK, Khaja N, Udayashankar SG, Venkatesha BK, Manjunath D. Clinico epidemiological study of complicated and uncomplicated chronic suppurative otitis media. J Laryngol Otol. 2008; 122(5):442-6.
Peyvandi, A. and N. A. Roozbahany (2013). "Hearing loss in chronic renal failure patient undergoing hemodialysis." Indian Journal of Otolaryngology and Head & Neck Surgery 65(3): 537-540.
Dohar JE. Old and new ototopical agents for the acute and chronic draining ear. Seminars in Otitis Media Management. 1998; 1-14.
Matsuda Y, Kurita T, Ueda Y, Ito S, Nakashima T. Effect of tympanic membrane perforation on middle-ear sound transmission. J Laryngol Otol. Suppl. 2009 ;(31):81-9.
Smith JA, Danner CJ. Complications of chronic otitis media and cholesteatoma. Otolaryngol Clin North Am. 2006; 39(6):1237-55.
Hannley MT, Dennenny JC 3rd, Holzer SS. Use of ototopical antibiotics in treating 3 common ear diseases. Otol Head Neck Surg. 2000; 122(6):934-40.
Barati B, Abtahi SHR, Hashemi SM, Okhovat SAR, Poorqasemian M, Tabrizi AG. The effect of topical estrogen on healing of chronic tympanic membrane perforations and hearing threshold. J Res Med Sci. 2013; 18(2):99-102.
Wright D, Safranek S. Treatment of otitis media with perforated tympanic membrane. Am Fam Physician. 2009; 79(8):650-654.
Kenna MA. Etiology and pathogenesis of chronic suppurative otitis media. Ann Otol Rhinol Laryngol. 1988; 97:16-17.
van der Veen EL, Schilder AG, van Heerbeek N, Verhoeff M, Zielhuis GA, Rovers MM. Predictors of chronic suppurative otitis media in children. Arch Otolaryngol Head Neck Surg. 2006; 132(10):1115-8.
Carrillo RJ, Yang NW, Abes GT. Probabilities of ossicular discontinuity in chronic suppurative otitis media using pure-tone audiometry. Otol Neurotol. 2007; 28(8):1034-7.
Ebenezer J, Rupa V. Preoperative predictors of incudal necrosis in chronic suppurative otitis media. Otolaryngol Head Neck Surg. 2010; 142(3):415-20.
Jeng FC, Tsai MH, Brown CJ. Relationship of preoperative findings and ossicular discontinuity in chronic otitis media. Otol Neurotol. 2003; 24(1):29-32.
Dadgarnia MH, Karimi GH. The prevalence of cholesteatoma in patients with chronic otitis media and the comparison of postoperative results in patients with and without cholesteatoma. J Rafsanjan Univ Med Sci. 2005; 4(1):49-55. [Persian].
Feng H, Chen Y, Ding Y. Analysis of preoperative findings and ossicular condition in chronic suppurative otitis media. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2005; 19(1):7-8, 11. [Chinese].
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