Pre and Post Operative Status of Contralateral Ear in Unilateral Chronic Otitis Media.

Abstract

Chronic otitis media (COM) is one of the oldest disease affecting ears and undoubtedly represents the main area of interest within modern otology. As the main cause of COM is malfunction of Eustachian tube, it is probable that a patient with COM will have a disorder in contralateral ear (CLE) as suggested by the Minneapolis group- called as Continuum Theory. This prospective, observational study was conducted in department of ENT at a tertiary care centre of central India from Sep 2012 to May 2015. Study consisted of 537 patients of unilateral COM who fulfilled the eligibility criteria. After careful history and thorough examination of diseased ear and CLE, findings of diseased ear, CLE and 6months postoperative findings CLE were entered into performa. The data was entered into SPSS software and further analysis was performed. Out of 740 patients of COM operated in our department, 535 (72.9%) patients had unilateral COM which were included in the study. The mean age was 24.3 (SD±10.63) ranging from 11 to 55years, of these 51.4% were females and 48.6% were males. Out of 535 unilateral COM, 365 (68.2%) had mucosal while 170 (31.8%) had squamous type of disease and 30.9% of total CLE had abnormal findings. The pre and post-operative findings were compared which came out to be statistically significant and there was significant difference in pre and post-op PTA also (0.001). The significant improvement in postoperative status of CLE achieves our objective and also strongly supports the theory of Continuum. The unilateral COM should not be taken as a static phenomenon but as a continuous process in other ear too. We could also shows a significant improvement in the CLE after treatment of diseased ear, this knowledge can be effectively used in therapeutic planning of diseased ear, counselling of patient regarding other ear and if necessary providing therapeutic intervention in the other ear at the earliest.