Endoscopic evaluation of the patency of the aditus in tubotympanic type of chronic suppurative otitis media

Mohammed Bassiouny,Mohamed Yassin,Yasser G Shewel

doi:10.4103/1012-5574.175846

Abstract

Abstract Endoscopic evaluation of the aditus in tubo-tympanic chronic suppurative otitis media (CSOM). Prospective escriptive study. This study carried out on 50 patients presenting with inactive tubo-tympanic CSOM with only mild or moderate conductive hearing loss, attending the Alexandria university hospital (tertiary referral center). Tympanoplasty was done for all patients. The patency and dimensions of the aditus were assessed by performing antral window through which 30Ί endoscope was introduced. Biopsy was taken from unhealthy mucosa to detect the presence of hidden cholesteatoma or granulation tissue. Ten out of 50 (20%) patients had blocked aditus. The dimensions of the aditus were measured. Biopsy taken from these cases revealed a granulation tissue in all cases. No hidden cholesteatoma was detected. In inactive tubo-tympanic CSOM with mild or moderate conductive hearing, the aditus was not always patent. It was obstructed in 20% of our study.

Highlights

Tympanoplasty has been the mainstay of treatment in tubotympanic chronic suppurative otitis media (CSOM) [1]
In this study we aimed to evaluate endoscopically the patency of the aditus in cases of tubotympanic CSOM and to measure dimensions of aditus
We examined histologically its mucosa if abnormal to detect the presence of hidden cholesteatoma or granulation tissue, so as to assess the usefulness of cortical mastoidectomy together with myringoplasty in cases of tubotympanic CSOM

Summary

Introduction

Tympanoplasty has been the mainstay of treatment in tubotympanic chronic suppurative otitis media (CSOM) [1]. The usefulness of cortical mastoidectomy together with tympanoplasty in the management of tubotympanic CSOM has been a very long debate [1]. Some argue that it would enhance the aeration of the mastoid cells and the middle ear and better results and less failure rates can be obtained following myringoplasty [2,3]. Others argue that it adds morbidity to the patients and increases the risk of better-avoided complications such as vertigo, sensorineural hearing loss, or facial nerve palsy [4]. If cortical mastoidectomy adds more benefits, should it be performed on all patients or only on those fulfilling certain criteria

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