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

Carrillo, Ryner Jose C.; Yang, Nathaniel W.; Abes, Generoso T.

doi:10.1097/mao.0b013e31815882a6

Cited by 32 publications

(29 citation statements)

References 7 publications

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“…Regarding hearing function, ABG in patients affected by chronic otitis media is usually related to the ossicular chain condition; in particular, a narrow ABG would suggest ossicle integrity, whereas a wide ABG would predict ossicular resorption [ 7 ]. This was not fully confirmed by our study.…”

Section: Discussioncontrasting

confidence: 73%

Ossicular Chain Lesions in Tympanic Perforations and Chronic Otitis Media without Cholesteatoma

Albera

Dagna²,

Filippini³

et al. 2015

Int Adv Otol

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OBJECTIVE:The first aim was to determine the prevalence, kind, and functional effects on hearing of ossicular chain suffering (OCS) in chronic otitis without cholesteatoma (NCOM) and tympanic perforations (TP). The second aim was to correlate the findings with clinical parameters and hearing level. MATERIALS and METHODS:The study group comprised 250 consecutive patients affected by NCOM and who were subjected to tympanoplasty and never operated on before. Each patient underwent preoperative pure tone audiometry. Ossicles were evaluated during surgery. The incidence of OCS in NCOM was reported in 15-62% of the patients. RESULTS:Ossicular chain suffering was found in 26 out of the 250 patients included in the overall sample (10%). It was found in 7% of the patients affected by TP without otorrhea and in 19% of the patients affected by chronic ear discharge with drum perforation. OCS was found most frequently in posterior eardrum perforations and in patients with bilateral disease. The incus was the ossicle most frequently interested by resorption (92% of the patients). The air conduction threshold and air bone gap were more impaired in NCOM than in TP.CONCLUSION: Ossicular chain damages in patients with non-cholesteatomatous middle ear pathologies are not frequent and are present in no more than 10% of the patients, but lesions found were similar to those reported in patients with cholesteatoma. Otorrhea, posterior perforation, and bilateral disease can be considered as good predictors of OCS.

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Section: Discussioncontrasting

confidence: 73%

Ossicular Chain Lesions in Tympanic Perforations and Chronic Otitis Media without Cholesteatoma

Albera

Dagna²,

Filippini³

et al. 2015

Int Adv Otol

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“…This was supported by Ryner Jose C stating that although mastoidectomy may be done on simple TM perforations there was no clear advantage for its routine practice in CSOM in absence of active infection or disease. 13 In contrast to our study, a study conducted by Holmquist et al suggested that mastoidectomy improves the chance of successful tympanoplasty for patients with noncholesteatomatous chronic otitis media. They maintained that creation of an aerated mastoid enhances success in patients with poor tubal function or a small mastoid air cell system.…”

Section: Discussioncontrasting

confidence: 53%

Comparative evaluation of surgical and audiological outcomes in patients of chronic suppurative otitis media with dry ear treated by myringoplasty with or without simple mastoidectomy

Kaur

Malik

Singh

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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INTRODUCTIONAmong the various causes of ear diseases, chronic suppurative otitis media (CSOM) is the major disorder in our country. CSOM is chronic inflammation of middle ear cleft which is composed of eustachian tube (ET), hypotympanum, mesotympanum, epitympanum, aditus, antrum, and mastoid air cells which presents with recurrent ear discharge or otorrhoea through a tympanic perforation.1 In India, prevalence rate is 7.8% which is very high. In Britain, 0.9% of children and 0.5% of adults have CSOM involving both the sexes equally. Worldwide, there are 65-330 million sufferers, among them 60% have significant hearing loss.According to Jackler et al many factors contribute to success or failure of surgery which are divided into mastoid and non-mastoid factors. 3 Holmquist and Bergstorm in 1978 said that well aerated mastoid is a prerequisite for well ventilated middle ear and long ABSTRACT Background: The study was conducted to compare and evaluate surgical and audiological outcomes in patients of chronic suppurative otitis media with dry ear treated by myringoplasty with or without simple mastoidectomy. Prospective, open label, randomized, comparative study, conducted in the Department of ENT, Ram Lal Eye and ENT hospital, Government Medical College Amritsar, Punjab, India. Methods: This study comprised of 40 patients aged between 15 to 50 years having CSOM (safe type) with dry ears for the last 3 months. Patients were randomly divided into Group A treated with myringoplasty alone and Group B with standard simple mastoidectomy along with myringoplasty using temporalis fascia graft by underlay technique. Patients also subjected to routine hematological, biochemical, radiological and audiological investigation. The audiological comparison done before and after surgery. Results: It was observed that graft uptake rate was better in group B. The average gain in air conduction threshold was more in patients who had undergone myringoplasty along with simple mastoidectomy. However this was not statistically significant. There was no significant improvement observed in the AB Gap in our patients who underwent myringoplasty or simple mastoidectomy along with myringoplasty. Conclusions: Hypocellularity of the mastoid process has a strong correlation with the tubotympanic type of CSOM. Addition of mastoidectomy to simple myringoplasty has a very little beneficial effect on the postoperative hearing gain and graft uptake as it showed no much statistical significance.

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“…16 Carillo et al studied Pure Tone Audiometric Thresholds in patients who underwent tympanomastoidectomy and found that a wide Air-Bone Gap at higher frequencies was more suggestive of incus necrosis. 17 In contrast to this, according to Jeng et al, Air-Bone Gap is not a good predictor of ossicular necrosis as granulations could bridge the defect between eroded ossicles thus reducing the Air-Bone Gap. 4 Presence of Middle ear granulations was found to be statistically significant predictor for ossicular necrosis in Ebenezer J et al and Jayakumar CL et al studies.…”

Section: Discussionmentioning

confidence: 93%

Study of Preoperative Indicators of Ossicular Defect in Mucosal Type of Chronic Suppurative Otitis Media

Harkare¹,

Khadakkar²,

Deosthale³

et al. 2020

jemds

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A B S T R A C T BACKGROUNDOssicular defect is although more common in squamosal type of chronic suppurative otitis media, it can also occur in mucosal type of the disease. Its preoperative knowledge not only helps surgeon to plan for ossicular reconstruction in a better way but also to counsel the patient accordingly. We wanted to determine the prevalence of ossicular chain defect and preoperative identification of clinical and audiological factors as indicators of ossicular defects in patients with Mucosal CSOM. METHODSThis is a hospital based cross sectional study of 2 years. Patients 15 to 60 years of age, having inactive mucosal type of Chronic Suppurative Otitis Media, posted for Tympanoplasty were included in the study. Findings on history, clinical, audiological and intraoperative otomicroscopic examination were recorded and analysed. RESULTSOssicular necrosis was noted in 21 (23.33%) of total 90 patients. On statistical analysis, patients of age >30 years (p=0.019, duration of ear discharge >10 years (p=0.003), those having large and subtotal perforation (p<0.001), adhesion of tympanic membrane edges to promontory (p=0.04), incudostapaedial joint area exposure (p=0.01) and air-one gap >40 dB (p <0.001) were found to be statistically significantly associated with ossicular erosion. CONCLUSIONSAll patients of mucosal type of chronic suppurative otitis media should be assessed in detail so as to get a clue of ossicular defects to be prepared for its repair and will not come as a surprise during surgery.

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

Cited by 32 publications

References 7 publications

Ossicular Chain Lesions in Tympanic Perforations and Chronic Otitis Media without Cholesteatoma

Ossicular Chain Lesions in Tympanic Perforations and Chronic Otitis Media without Cholesteatoma

Comparative evaluation of surgical and audiological outcomes in patients of chronic suppurative otitis media with dry ear treated by myringoplasty with or without simple mastoidectomy

Study of Preoperative Indicators of Ossicular Defect in Mucosal Type of Chronic Suppurative Otitis Media

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