Factors influencing ossicular status in mucosal chronic otitis media − An observational study

Abstract

Objective: To evaluate the influence of preoperative parameters on the status of ossicles in tubotympanic type of chronic suppurative otitis media. Materials and Methods: A total of 47 patients with mucosal type of chronic otitis media were evaluated for factors that influence ossicular status. A total of 14 preoperative parameters that are generally accepted to influence the ossicular status were examined and recorded. The same patients were subjected to surgery and their ossicular status was observed and noted peroperatively. Influence of each of the parameter on ossicular status was analyzed. P < 0.05 was considered as statistically significant. Results: Out of the 14 parameters that were studied, only 3 had a statistically significant influence on the ossicular status. These were, duration of the disease, adherence of the perforation edges to the promontory, pure tone average (PTA) and the air-bone gap (ABG). Duration of disease was significantly associated with ossicular discontinuity (P = 0.026). Adherence of margin of the perforation was seen in eight patients. A total of four among them had ossicular discontuinity and one among those who did not have this finding had ossicular discontinuity (P = 0.003). The mean PTA was 46.2 ± 20.1 db in patients with intact ossicular chain and 65.7 ± 14 db in patients with ossicular discontinuity (P = 0.04). Mean ABG was 23.9 ± 9.8 db in patients with intact ossicular chain and 35.1 ± 10.3 db in those with ossicular discontinuity (P = 0.001). Conclusion: Of the parameters studied, three were reliable to predict ossicular discontinuity in tubotympanic disease viz. duration of the disease, adherence of the margins of perforation to the promontory, PTA, and the ABG.