A study of relationship between preoperative hearing and intraoperative findings in squamosal type of chronic otitis media
Journal Title: Medpulse International Journal of ENT - Year 2019, Vol 9, Issue 3
Abstract
Objectives: 1. To find out the percentage of erosion of each ear ossicles 2. To find out the most susceptible and most resistant ear ossicles for erosion in chronic otitis media of squamosal type. 3. To study the relationship between preoperative hearing loss obtained by the pure tone audiogram and ossicular erosion seen intra operatively. Materials and method: It was a retrospective observational study in tertiary care center. 30 patients with chronic otitis media of squamosal type who had undergone canal wall down mastoidectomy from January 2018 to December 2018 and were above 18 years of age were included. The patients who underwent CWDM for other indications were excluded. The data was collected from the patients during their routine postoperative follow up about their preoperative hearing and intraoperative findings from operative notes. Chi Square test was used to study the association between preoperative hearing and ossicular status seen intraoperatively. Results: Otorrhoea was the most common presenting complaint(100%) followed by hearing loss (80%). Malleus was eroded in 50%, absent in 10% and normal in 40% cases. Incus was eroded in 63.33%, absent in 30% and normal in 6.66% cases. Stapes was eroded in 40% with absent suprastructure and was found to be normal in 60% cases. Overall 28 patients (93.33%) had ossicular erosion or absence. Incus was the most commonly eroded ossicle that was eroded or absent in all these 93.33% cases.29 patients (96.66%) had cholesteatoma in middle ear, aditus and mastoid cavity involving separately or in all of them in extensive cases. Granulations were seen similarly in 20 cases (66.66%) in these regions. Cholesteatoma and granulations were seen to involve either alone or in combinations. The Chi square test showed no statistical association grade of hearing loss and erosion of malleus (p=0.121), incus (p=0.505) and stapes (p=0.240). Conclusion: Ossicular discontinuity is a common complication of chronic otitis media of squamosal type. Variable percentage of erosion of ear ossicles was observed. Incus was most susceptible ear ossicles for erosion in chronic otitis media of squamosal type and stapes was most resistant ossicle for erosion. This study couldn’t establish any definite association between preoperative hearing status and ossicular status seen intraoperatively. The poor association of preoperative hearing status with ossicular chain discontinuity in the presence of cholesteatoma may be due to the latter’s ability to transmit sound(i.e. cholesteatoma hearer).
Authors and Affiliations
Ajit Lokare, Mukund Jadhav, Koustubh Khandake
Keywords
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- EP ID EP540004
- DOI 10.26611/1016938
- Views 155
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