Abstract
Aim: Chronic otitis media (COM) is chronic muco purulent discharge through a perforated tympanic membrane. Theossicular chain damage is found in both mucosal and squamosal types of COM. We aim to evaluate relationship between preoperative otologic features, pure tone audiometric findings and intraoperative ossicular chain status in patients with chronic otitis media. Material and Methods: 100 patients of either sex aged between 12 to 60 years operated for active or inactive, squamosal or mucosal chronic otitis media attending Ram Lal Eye and ENT Hospital, Government Medical College Amritsar were taken. The preoperative ossicular chain status based on set parameters was compared with the intraoperative ossicular chain status. Results: The ossicular chain integrity is more commonly compromised in squamosal COM and the most common ossicle eroded is Incus. Pure tone audiogram has got a very important role in determining the ossicular chain integrity preoperatively and must be done in all cases with accuracy. Conclusion: It is concluded that on the basis of otoscopic examination and pure tone audiometry values, we can accurately classify the COM as mucosal or squamosal type and get an idea of the ossicular chain integrity preoperatively hence planning the extent of surgery.
Highlights
Chronic otitis media (COM), is a commonly diagnosed condition in otorhinolaryngology, characterized by intermittent or persistent chronic purulent discharge through a perforated tympanic membrane [1]
We aim to evaluate relationship between preoperative otologic features, pure tone audiometric findings and intraoperative ossicular chain status in patients with chronic otitis media
On the basis of history and preoperative clinical findings, 76 cases were labelled as mucosal COM while remaining 24 cases were labeled as squamosal COM
Summary
Chronic otitis media (COM), is a commonly diagnosed condition in otorhinolaryngology, characterized by intermittent or persistent chronic purulent discharge through a perforated tympanic membrane [1]. Chronic middle ear inflammation is a result of overproduction of cytokines such as TNF-alpha, interleukin-2, fibroblast growth factor, and platelet derived growth factor. This promotes hypervascularization, osteoclast activation and bone resorption causing ossicular damage [2]. Ossicular chain damage is found in both mucosal and squamosal type of COM, more so in cholesteatoma cases. Erosion is a result of non specific hyperemia associated with mucosal inflammation. An area of inflammation stays in contact with a bone, resorption and remodelling takes place
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