Unilateral Chronic Otitis Media Research Articles

Evaluation of the Vestibulo-Ocular Reflex Using the Video Head Impulse Test in Patients with Unilateral Chronic Otitis Media

Introduction: The aim of the study was to evaluate the vestibulo-ocular reflex (VOR) using the video head impulse test (vHIT) as a vestibular function assessment method in patients with unilateral chronic otitis media (COM). Methods: Twenty-eight patients with unilateral COM scheduled for middle ear surgery, including 12 males and 16 females with a mean age of 54.5 years, successfully underwent preoperative vHIT. vHIT variables, including VOR gain, VOR gain asymmetry, and the incidence of corrective saccades, were compared between the ipsilesional and contralesional ears. Results: Ten (35.7%) patients reported varying degrees of disequilibrium or lightheadedness. The VOR gain in the ipsilesional and contralesional ears was 1.01 ± 0.10 and 1.04 ± 0.11, 0.97 ± 0.12 and 0.94 ± 0.13, and 0.97 ± 0.13 and 1.04 ± 0.15 in the horizontal canal (HC), anterior canal, and posterior canal (PC), respectively. The average VOR gains in the ipsilesional ears were within the predefined range of normal values; however, the gains in HC and PC significantly decreased compared with those in contralesional ears (p = 0.038 in HC and p = 0.015 in PC). The prevalence of corrective saccades, including overt and/or covert saccades, did not differ significantly between the two ears. Conclusion: This study assessed the pathophysiology of the inner ear affected by chronic middle ear infection by quantitatively comparing the VOR using vHIT. It demonstrated that vHIT can be a practical assessment of vestibular function in patients with COM.

There Is No Relation between Epitympanic Recess Volume and Chronic Otitis Media.

Chronic otitis media is recurrent infection of the middle ear and mastoid air cells in the setting of perforation of the tympanic membrane. Risk factors for chronic otitis media include predisposing characteristics such as gender, allergies, Eustachian tube dysfunction, history of acute otitis media, and upper respiratory tract infection. The purpose of this study was to evaluate the potential relationship between chronic otitis media and epitympanic recess volume. A total of 197 patients with chronic otitis media had their epitympanic recess volume compared to the epitympanic volume of 99 healthy controls. The epitympanic recess volume was measured via the 3D volumetric measurement tool of the local PACS. Epitympanic recess volume measurement was performed using axial sections in a plane starting from the level of the malleus head-anvil body in the craniocaudal direction to the tegmen tympanum. It was shown that patients with bilateral involvement had an epitympanic recess volume of 75.00 mm3, compared to 72.30 mm3 in those with unilateral chronic otitis media. The healthy control group's median value for the epitympanic recess was 74.73 mm3. Epitympanic volume values did not differ substantially between patients with chronic otitis media and healthy persons, and epitympanic volume was not recognized as a predisposing factor (p = 0.686).

Eustachian Tube Function Test of Normal Ear in Patients with Unilateral Chronic Otitis Media

Purpose: The aim of this study is to observe the importance of normal ear Eustachian Tube Function Test (ETFT) for unilateral Chronic Otitis Media (COM) and essential date on ETFT through Williams test (Y-266 Hz).Methods: Williams test Y-226 Hz is a test that can evaluate the function of the Eustachian tube only by controlling the pressure, and we retrospectively analyzed 182 otitis media patients who underwent surgery in Pusan National University Hospital. Three results obtained through the Williams test (Y-226 Hz) were classified according to categories and descriptive analysis was performed.Results: In the 182 subjects, 89 did not show changes in static compliance (SC) or had result bias. 1~5 daPa change in 6 (3.3%), 6~10 daPa change 17 (9.3%), 11~15 daPa change 18 (9.9%), 16~20 daPa change 22 (12.1%), 21~25 daPa change 5 (2.7%), 26~30 daPa change 5 (2.7%), 31~40 daPa change 4 (2.2%), 41~50 daPa change 6 (3.3%), 51~100 daPa change changes in 6 (3.3%) and the remaining 4 (2.2%) showed a change greater than 100 daPa. The mean standard SC value of 93 subjects with change was -4.9 daPa, and the mean value measured at positive pressure +400 daPa was -27.4 daPa. Additionally, the mean value measured at negative pressure -400 daPa was +22.9 daPa.Conclusion: Even if the contralateral eardrum appeared normal in the subjects who underwent COM, there were more cases of problems with the Eustachian tube. Normal ear ETFT is necessary for unilateral COM patients, and the Williams test is suitable as a criterion-referenced assessment.

Could tympanometric volume be a useful tool to predict the success of type I tympanoplasty in simple chronic otitis media

Background: Middle ear aeration level is an important precursor of chronic otitis media (COM) and one predictive factor for tympanoplasty success. Tympanometry measures the volume of the external ear canal, middle ear cavity, aditus, and mastoid air cells in patients with tympanic membrane (TM) perforation. The aim of the study was to determine whether the pre-operative tympanometric volume and the interaural tympanometric volume differences in unilateral simple COM can predict the success of type I tympanoplasty. Methods: Retrospective analysis of type I tympanoplasties performed in adults between January 2017 and December 2020 in a tertiary hospital. Bilateral COM, revision surgery and tympanoplasty using cartilage grafts or associated with other procedures were excluded. Success was defined as no evidence of TM perforation on otoscopic examination and tympanogram, at least six months after surgery. Results: Sixty-one patients were evaluated. The mean age was 43 years old, and there was a female predominance (55.7%). The overall success rate was 77%. Location or size of perforation weren’t different among patients with and without surgical success. We found a statistically significant result (p=0.009) regarding interaural tympanometric volume differences, with a median of 2.7 ml (IQR 3.6) in the surgical success group and a median of 1.3 ml (IQR 1.26) in the recurrence group. 90.6% of patients with interaural tympanometric volume difference greater than 2 ml had successful surgery. Conclusions: A good aeration of middle ear, demonstrated by higher interaural tympanometric volume differences, can predict success of type I tympanoplasty.

Correlation of Mastoid Pneumatization with Middle Ear Pathology in Unilateral Squamous Type of Chronic Otitis Media

Introduction: Chronic otitis media is chronic inflammation of middle ear cleft followed by permanent abnormality of tympanic membrane. As mastoid a part of temporal bone is in close relation to middle ear; its pneumatization plays an important role in pathogenesis and prognosis of chronic otitis media.
 Aims: To study the pneumatization pattern of mastoid in unilateral chronic otitis media and its relationship with contralateral mastoid, diseased side tympanic membrane and ossicular status.
 Methods: Forty patients of 10-65 year of age diagnosed as unilateral chronic otitis media squamous type were selected. They were otoscopically evaluated for retraction and perforation of tympanic membrane and were subjected to high-resolution computed tomography of temporal bone. High resolution computed tomographies were analyzed for mastoid status of bilateral ear and ossicular involvement. During mastoidectomy ossicular status was noted and correlated with high resolution computed tomography.
 Results: Forty cases were enrolled in the study. Age ranged from10-65 years. On radiological analysis of temporal bones, 21(52.5%) mastoids were sclerotic, 15(37.5 %) mastoid diploic and 4(10%) were pneumatized in the diseased sides. Contralateral side showed pneumatization in 23(57.5%), diploic in 11(27.5%) and sclerotic in 6(15%) Amongst 21 sclerotic mastoid, 11(52.3%) patient had retraction in pars tensa and 9(42.8 %) had retraction of pars flaccida. In total 15 diploic mastoids retraction of pars tensa was in 8(53.3%) and pars flaccid retraction in 8(53.3%) All three ossicles were involved in 8(38%), Malleus and incus were eroded in 3(14%), incus were eroded in 7(33.3%), malleus were eroded in 3(14%) and ossicles were intact in 3(14%)of 21 sclerosed mastoids on high resolution computed tomography. In remaining 19 non sclerotic mastoids all 3 ossicles were eroded in 4 (21%), malleus plus incus eroded in 8 (16%), incus were eroded in 5(26.3%) andossicular chain was intact in 2(10%).
 Conclusion: Mastoid pneumatization pattern not only effect to the pressure of middle ear leading to chronic otitis media but also alter the pathogenesis and outcome of chronicotitismedia. Contralateral mastoid pneumatization is not altered in unilateral Chronic otitis media.

Status of Contralateral Ear in Patients with Unilateral Chronic Otitis Media.

This study was conducted to evaluate the existence of otoscopic abnormality, hearing status and radiological changes in contralateral ear of patients with chronic otitis media. 300 patients having unilateral Chronic Otitis Media attending OPD in the Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi during the period of March 2019 to March 2020 were selected. Otoscopy, Pure Tone Audiometry and Bilateral X-ray mastoids (lateral oblique view) and/or HRCT Temporal bone were done. Contralateral ear was affected in more than 30% cases. Out of 188 patients having Mucosal COM, 58 cases (30.9%) had abnormal TM. Out of 112 patients having Squamosal COM, 48 cases (42.9%) had abnormal CLE. Out of 300 cases, 231 (77.0%) of them had normal hearing in contralateral ear. It was followed by 65 cases (21.6%) with conductive hearing loss. Mixed hearing loss and SNHL were seen in 2 patients each. In contralateral ear of Mucosal COM, pneumatic pattern of pneumatisation was seen in 69.1% followed by Diploic pattern (30.9%). In squamosal COM, X-ray mastoid showed pneumatic pattern (64.3%) followed by Diploic pattern (33.9%) in the contralateral ear. Sclerotic pattern was seen in only 1.8% of cases in contralateral ear. Chronic otitis media as a disease is not limited to one ear. The precise and critical evaluation of both ears does not play a role in prognostic evaluation of the patient only, but it can also serve as a guide for early detection of probable evolution of the disease process in a patient in contralateral ear with unilateral chronic otitis media.

A Cross-Sectional Study on the Status of Contralateral Ear in Cases with Otitis Media Attending a Tertiary Care Center

Background As the aeration and drainage entrances in both ears are the same, the factors that produce otitis media in one ear may also affect the other. Also, the unsolved debate is that long-standing otitis media turns into chronic otitis media (COM). Hence, this study was conducted with the objective of assessing the incidence of abnormal findings in the contralateral ear (CLE) and to find the association between the type of COM of diseased ear with the findings of CLE. Materials and Methods A hospital-based cross-sectional study was conducted among cases with unilateral COM who visited the outpatient department of otorhinolaryngology at Chettinad Hospital and Research Institute in Chennai between November 2021 and February 2022. The study comprised 200 COM cases in all. The medical history, otoscopic examination, pure-tone audiometry, and tympanometric findings of the patient were all documented. SPSS version 20 was used to conduct the analysis. Results About 80% of the individuals with COM in one ear exhibited some abnormalities in the CLE. The type of COM in the afflicted ear is not linked with the otoscopic findings, type of hearing loss, tympanometric findings, or overall abnormalities in the CLE. This study’s findings are comparable to those of several others. Conclusion Though there is no association between type of COM and the pathological findings in the CLE, considering the huge burden of pathological findings noted in the CLE, all cases of unilateral COM should be screened for aberrant findings in the CLE.

Effects of Nasal and Paranasal Sinus Variations on Chronic Otitis Media Development in Pediatric Patients.

Chronic otitis media is an inflammatory disease of the middle ear. The airflow in the nasal passage affects the development of mastoid air cells through the eustachian tube.Nasal and paranasal pathologies and their anatomical variations cause chronic sinonasal inflammation and affect the middle ear mucosa. This study aims to reveal whether the nasal and paranasal sinus variations in pediatric patients are a factor in developing chronic otitis media. Eighty patients, with unilateral chronic otitis media, who were admitted to the otorhinolaryngology clinic between May 2015 and July 2019, were included in this retrospective study. The control group (Group 2) consisted of a total of 51 patients. None of the patients in Group 2 had otorrhea history and no signs of chronic otitis in their otoscopic examination, middle ear pathologies. The patient's anatomical variations of the nasal cavity and sinuses were evaluated with CT by a radiologist Results: Nasal septum deviation was found to be 53% in children with chronic otitis media. It was found 31.4% in the control group. Since the P value was found to be .04, this rate was considered as significant. Inferior concha hypertrophy was found to be 17.6% in the control group and 38.8% in the group with chronic otitis media, and this rate was considered significant since the P value was .035 Conclusion: We detected that septum deviation and inferior concha hypertrophy increased chronic otitis media formation in children. All these studies show that cases causing nasal obstruction, such as septum deviation, have a negative effect on middle ear pressure and increase the rate of ear diseases.

Tympanometry and computed tomography measurement of middle ear volumes in patients with unilateral chronic otitis media

<p class="abstract"><strong>Background: </strong>Tympanometry and computed tomography (CT) measurement of middle ear volume in patients with unilateral chronic otitis media.</p><p class="abstract"><strong>Methods: </strong>The prospective study was conducted on 50 patients of diagnosed unilateral chronic otitis media showing clinical symptoms which affect quality of life. Patients who were fulfilling inclusion criteria after screening were selected for study. We studied patients who had a unilateral tympanic membrane (TM) perforation and a normal TM in the contralateral ear which act as control group to estimate the ME volume in the lesioned ear. Further we have compared pre and postoperative middle ear volume (measured by CT and tympanometry) in control & diseased ear to correlate middle ear volume results obtained by CT and Tympanometry.</p><p class="abstract"><strong>Results: </strong>The mean value of MEV measured by tympanometry and CT were (1.343±0.580) and (1.106±0.380) respectively (Figure 1). Volume measurement by tympanometry is higher as compared to volume measured by CT in lesioned ear, hence tympanometry measured volume in diseased ear were higher that measured by CT which is closer to normal values in both normal and Diseased ears. Also hearing shows improvement in diseased ear after surgery due to restoration of middle ear volume closer to normal.</p><p class="abstract"><strong>Conclusions:</strong> It was concluded in our study that CT is more reliable investigation for middle ear volume measurement as compared to Tympanometry in diseased as well as normal ears.</p>

Study of the Reliability of High Resolution CT Scan Evaluation of Eustachian Tube as Predictor of Predisposition for Chronic Otitis Media.

Eustachian tube (ET) dysfunction is one of the predisposing factors for chronic otitis media (COM). This study looks at two parameters in High Resolution Computed Tomography of temporal bone namely tubotympanic angle (TTA) and pretympanic diameter (PTD) and its relationship with COM. The objectives of the study were tocompare the tubotympanic angle and pretympanic diameter of the affected ear in patients with unilateral COM with that of healthy controls, and with contralateral non-COM ear. This was a retrospective study done at a tertiary referral hospital. Database of patients who underwent high resolution CT scan of temporal bone over a period of three and half years, was studied. The TTA and PTD of ET were measured with the help of a senior radiologist well-versed in the imaging of temporal bone. Group A consisted of 45 patients with unilateral COM, while Group B comprised 50 patients without COM. Group A was further subgrouped as A1 (COM with cholesteatoma) and A2 (COM without cholesteatoma). The TTA and PTD in COM with cholesteatoma in the affected ear were 147.98 ± 5.89° and 2.84 ± 0.82mm respectively, and in the unaffected ear, 144.81 ± 6.43° and 3.32 ± 1.19mm respectively. In Group A, the TTA and PTD in the affected ear of unilateral COM were 146.17 ± 6.11°, 2.97 ± 0.87mm and in Group B, it was 143.17 ± 6.01° and 3.48 ± 0.85mm respectively. All these were statistically significant (p value < 0.05). Increased TTA and reduced PTD of ET may be a predisposing factor for the development of COM and cholesteatoma.

Relationship between Eustachian Tube Dimensions and Middle Ear Cholesteatoma

Objective: To compare intact and diseased ears for Eustachian tube (ET) length and width in patients with unilateral chronic otitis media (COM), and to assess the relationship between cholesteatoma spread, stapes erosion, lateral semicircular canal (LSCC) fistula and ET width and length retrospectively. Methods: Subjects with unilateral COM (122 subjects with 244 ears) who underwent surgery for cholesteatoma were evaluated retrospectively for this study. The width of the distal orifice of the bony segment and the length of the bony segment of the ET for both the diseased and healthy ear were measured. Subjects’ healthy and diseased ears were compared for ET length and width. The diseased sides were compared to assess the relationship between ET dimensions and cholesteatoma spread, stapes erosion and LSCC fistula. Results: The mean ET length and width in healthy and diseased ears was 11.38±1.7 and 1.43±0.37 mm, and 10.99±1.6 and 1.27±0.35 mm, respectively; the difference was statistically significant (p<0.001). No significant differences were found in terms of ET length and width between the subjects with and without stapes erosion and LSCC fistula (p=0.765, p=0.573, and p=0.436, p=0.790, respectively). No significant relation was found between cholesteatoma spread and ET length and width (p=0.647). Conclusion: ET dysfunction is frequently associated with COM. Chronic otitis media with cholesteatoma is significantly related to ET length and width. Measurement of ET length and width in CT scans is a basic method that can be used in clinical practice.

Comparative evaluation of mastoid pneumatization pattern using X-ray mastoid and high-resolution computed tomography temporal bone in unilateral squamosal chronic otitis media

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic otitis media (COM) affects 0.5-30% of individuals in any community and over 20 million people are estimated to suffer from this condition worldwide. COM often evolves in a continuum. Squamosal disease is more commonly found in poorly pneumatized bones, but whether the sclerosis is relevant to the etiology of the disease or is caused by it, has not been fully resolved. Our study aimed at comparing the mastoid pneumatization patterns obtained using X-ray mastoid and high-resolution computed tomography (HRCT) temporal bone. It was an interventional study.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Sixty patients of unilateral squamosal COM, aged more than 8 years, underwent X-ray mastoid Schuller’s view and HRCT temporal bone, using Philips extended brilliance 48 slice CT. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Upon analysis, in diseased and healthy ears, the coincidence of X-ray and HRCT findings was 63.33% and 80% respectively.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; HRCT temporal bone should be done in all cases of squamosal COM to know the extent of the disease, pneumatization patterns and the presence of anatomical variations. &lt;/p&gt;

Evaluation of Contralateral Ear in Unilateral Chronic Otitis Media: Necessary or Not?

Eustachian tube appears to be central to the pathogenesis of all forms of otitis media. The reported frequency of bilateral disease ranges from 27 to 55%. The affected ear may well be the end point of the pathology in the contra lateral ear (CLE). Cross sectional observational study. One hundred patients who had unilateral chronic otitis media (COM) were enrolled in the study. Diseased ear was divided into either mucosal or squamosal type. Otoendoscopy, pure tone audiometry, impedance audiometry and X-ray mastoid (Schuller's view) findings of CLE were noted. Considering all the changes including tympanic membrane, X-ray mastoid, hearing assessment and tympanometry, we found that 70% of patients had alterations in the CLE. Our study was consistent with many previous studies that there was an increased risk of COM in the CLE of unilateral COM.

A study of status of contralateral ear in unilateral chronic otitis media in 500 patients

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The aim of this study was to examine the contralateral ear clinically, audiologically and radiologically and compare the findings with squamous and mucosal type of chronic otitis media (COM).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A cross sectional study conducted in patients attending ENT Department, Government Medical College, Amritsar between December 2016 to November 2018. The study was conducted in 500 patients of either sex aged between 8 to 60 years with unilateral COM without perforation or history of ear discharge in the contralateral ear. Otoscopy, pure tone audiometry and X-ray mastoid or high-resolution computed tomography temporal bone were done on the patients. The results were recorded and analysed with SPSS software. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 82% patients were found to have some abnormalities in the contralateral ear. On otoscopy abnormalities in contralateral ear includes retraction of tympanic membrane, thinning and tympanosclerotic patch, most common abnormality being retraction of tympanic membrane. Radiological analysis of contralateral mastoids showed 39% diploic and 22.8% sclerotic mastoids. Hearing status in the contralateral ear showed 45.6% patient with normal hearing, 48.6% with conductive hearing loss and 5.8% with mixed hearing loss. 40.4% contralateral ears had mild, 12% had moderate and 2% had severe hearing loss.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Contralateral ear pathologies were more in those who had squamosal type of COM than who had mucosal type in the diseased ear. The contralateral ear shows unmistakable predilection towards developing COM in the future.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Possible Effect of Chronic Otitis Media with and without Cholesteatoma on Bone Conduction Thresholds: Evaluation of the 112 Cases

Objective: The aim of this study is to evaluate any possible effects of chronic otitis media (COM), with or without accompanying cholesteatoma, on bone conduction thresholds (BCT). Methods : A total of 112 cases who underwent surgery for unilateral COM between 2006 and 2014 were enrolled in the study. Eighty cases had no cholesteatoma (Group 1). Thirty-two cases did have cholesteatoma (Group 2). Prior to surgery, the temporal bone was evaluated radiologically by use of high resolution computed tomography. The presence of a clinically and radiologically normal contralateral ear was the principal selection criterion for the cases. BCT at 0.5, 1, 2, 4 kHz and their averages were evaluated with pure tone audiogram (PTA) and the normal and diseased ears in each group were compared. This comparison was also made between the diseased ears in Groups 1 and 2. Results: There was a statistically significant difference observed between the mean BCT scores obtained by PTA for the normal/diseased ears in Group 1 (9.78±0.98/17.34±1.71 dB) and in Group 2 (9.10±0.99/17.58±2.59 dB). This statistically significant difference was observed for each of the four different frequencies (p<0.0001). However, there was no statistically significant difference observed between the mean BCT scores obtained by PTA for the diseased ears in Groups 1 and 2 (17.34±1.71/17.58±2.59 dB). Similarly, in the comparison between the diseased ears, the differences of BCT at all four different frequencies (0.5, 1, 2, 4 kHz) lacked statistical significance (p>0.05). Conclusion: As a result of this study, we can say that COM may lead to sensorineural hearing loss. However, we observed that the presence of cholesteatoma does not exert an additional negative effect on cochlear function.

Evaluation of the contralateral ear in patients with unilateral chronic otitis media

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Unilateral chronic otitis media (COM) is a condition likely to affect the other side also caused by various etiological factors. If diagnosed and intervened in time, the progression of the disease can be prevented and ear can be protected from various sequelae. Hence, it is important to assess and evaluate the contralateral ear (CLE) completely.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective study of 12 months was conducted in the Otorhinolaryngology department, enrolling 80 patients with unilateral chronic otitis media. The CLE defined as the asymptomatic ear without ear discharge or any other complaints. Otoscopy, pure tone audiometry, tympanometry and X-ray mastoid done on patients. The results were recorded and analysed. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; On otoscopic findings 76.36% patients in mucosal and 88% patients in squamosal showed abnormalities in CLE. Pure tone audiometry (PTA) showed 75% patients had hearing loss in CLE 46.25% conductive hearing loss (HL), 11.25% sensorineural HL and 17.5% mixed HL in CLE. In squamosal type of COM 76% patients had hearing impairment as compared to mucosal type 74.54%. In tympanometry findings 58.75% patients had type B curve in CLE. Radiographic finding of CLE showed sclerotic mastoid air cells 32% in squamosal and 9.09% in mucosal type.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Approximately 80% patients with unilateral COM have abnormal ear findings in CLE. Squamosal type of unilateral COM had more chances of abnormalities in CLE. In this study results showed that the CLE can also be affected in unilateral COM.&lt;/p&gt;

The Contralateral Ear in Unilateral Chronic Otitis Media - Does it Need Reckoning ?

Introduction&#x0D; This comparative study aims to analyze findings and their significance in the contralateral ears of patients with unilateral Chronic Otitis Media (COM) and compare it with a control group of healthy subjects.&#x0D; Materials and Methods&#x0D; One hundred patients of unilateral COM and 100 healthy individuals were included in this study from Jan 2015 to July 2016. The findings were noted in the contralateral ears of patients with unilateral COM and 100 control subjects. The changes found in the contralateral ears were assessed statistically for significance.&#x0D; Results&#x0D; In 100 cases of unilateral COM, 58 patients had some abnormality in the contralateral ear. Myringosclerosis patches being the most common finding were seen in 29 patients followed by TM retractions seen in 28 patients. Prevalence of abnormal findings was found to be significantly higher in the squamous group as compared to the mucosal group. In 100 ears in the control group, only 11 % had positive findings. TM retractions were seen in 5 subjects (3 Attic and 2 Pars tensa retractions). &#x0D; Conclusion&#x0D; It can be statistically concluded that the disease of COM in one ear affects the contralateral ear slowly and silently. Hence both ears are affected as pairs and a slow pathological process continues behind an intact TM and kept hidden from the view unless it is actively sought for. Contralateral ears should also be actively followed up, in cases of unilateral COM in order to pick up disease harboring silently.

Evaluation and significance of Eustachian tube angles and pretympanic diameter in HRCT temporal bone of patients with chronic otitis media.

ObjectiveTo evaluate the significance of Eustachian tube (ET) angles and ET pretympanic diameter on high resolution computed tomography (HRCT) Temporal bone in patients with chronic otitis media (COM).MethodsA retrospective study was carried out at Tertiary care centre. Group A included 92 ears with COM (38 patients with bilateral COM and 16 with unilateral COM); and Group B included 108 normal ears (54 patients with bilateral normal ears). Reid plane-ET angle, Tubotympanic angle and the ET pretympanic diameter was evaluated by HRCT temporal bone, and compared in the two groups. Patients with chronic otitis media (Group A) were subdivided into Group A1 (Blocked ET) and Group A2 (Patent ET). The parameters were evaluated and compared in the subgroups too.ResultsThe mean Reid plane-ET angle and Tubotympanic angle in Group A was 25.41 ± 2.57 and 148.12 ± 3.43 respectively; whereas in Group B it was 27.56 ± 3.62 and 145.14 ± 4.34 respectively. Reid plane-ET angle was significantly less in patients with COM and Tubotympanic angle was significantly more obtuse in COM patients. ET pretympanic diameter was (5.37 ± 2.10) mm in Group A and (6.47 ± 2.40) mm in Group B. It was significantly less in patients with COM. A significant correlation was found between the ET patency and the two ET parameters (Reid plane-ET angle and pretympanic diameter).ConclusionsEustachian tube angles in adults may play a significant role in the etiology of chronic otitis media. Decrease in Reid plane-ET angle and pretympanic diameter on HRCT temporal bone can be used to predict ET dysfunction and to plan the surgical management of chronic otitis media.

Assessment of nasal functions and their relationship with cholesteatoma formation in patients with unilateral chronic otitis media.

To evaluate the nasal functions of patients with unilateral chronic otitis media using rhinomanometry, comparing chronic otitis media sides with healthy sides, chronic otitis media patients with cholesteatoma and without cholesteatoma, and patients with healthy individuals. This prospective study included 102 patients with unilateral chronic otitis media (48 with and 54 without cholesteatoma). The control group comprised 40 individuals without any ear or nasal pathologies. All patients underwent active anterior rhinomanometry to measure nasal airway resistance and a saccharin test to measure mucociliary transport times. There were no significant differences in nasal airway resistance and mucociliary transport time between the chronic otitis media sides and unaffected sides in the 102 patients (p = 0.72 and p = 0.28, respectively), between the non-suppurative chronic otitis media patients (without cholesteatoma) and chronic otitis media with cholesteatoma patients (p > 0.05), or between the study and control groups (p > 0.05). The present study, with a larger sample size compared to previously published literature, supports the conclusion that unilateral nasal obstruction is unlikely to lead to chronic otitis media on the same side. The results also suggest that nasal functions do not contribute to the development of cholesteatoma.

Effect of drill noise on contralateral hearing after mastoidectomy in cases of unilateral Chronic Otitis Media

Introduction: The mainstay of treatment of Chronic Otitis Media (COM) is Tympanoplasty with or without Mastoidectomy. This study was conducted in patients undergoing Tympanoplasty with Mastoidectomy to assess Sensorineural Hearing Loss (if any) due to drill noise on the contralateral ear. Materials and Methods: A total of 25 patients with unilateral COM scheduled to undergo Mastoidectomy and Tympanoplasty who fulfilled inclusion criteria were recruited in the study, and a prospective, observational pilot study was carried out. Pure Tone Audiometry (PTA) and Transient Evoked Otoacoustic Emissions (TEOAE) were recorded preoperatively and postoperatively to assess hearing loss if any on the contralateral side. Results: There was no change in bone-conduction thresholds in the contralateral ear by PTA postoperatively. However, there was a significant worsening in the values of signal-to-noise ratio of TEOAE at all the frequencies in the postoperative period. The mean TEOAE recordings were, however, above 3 dB SPL. Conclusion: There are statistically significant effects of drill noise on the inner ear function on the contralateral ear as detected by TEOAE; however, the effects are not detectable on PTA. Larger studies with a longer follow-up period will be required to determine if the early postoperative effects on TEOAE are reversible or persist.