Relation between Ossicular Erosion and Destruction of Facial and Lateral Semicircular Canals in Chronic Otitis Media

Abstract

Introduction Chronic otitis media can cause multiple middle ear pathogeneses. The surgeon should be aware of relation between ossicular chain erosion and other destructions because of the possibility of complications. Objective This study aimed to investigate the rates of ossicular erosion in cases of patients with and without facial nerve canal destruction, who had undergone mastoidectomy due to chronic otitis media with or without cholesteatoma. Methods We retrospectively analyzed three hundred twenty-seven patients who had undergone tympanomastoidectomy between April 2008 and February 2014. We documented the types of mastoidectomy (canal wall up, canal wall down, and radical mastoidectomy), erosion of the malleus, incus and stapes, and the destruction of facial and lateral semi-circular canal. Results Out of the 327 patients, 147 were women (44.95%) and 180 were men (55.04%) with a mean age 50.8 ± 13 years (range 8–72 years). 245 of the 327 patients (75.22%) had been operated with the diagnosis of chronic otitis media with cholesteatoma. FNCD was present in 62 of the 327 patients (18.96%) and 49 of these 62 (79.03%) patients had chronic otitis media with cholesteatoma. The correlation between the presence of FNCD with LSCC destruction and stapes erosion in chronic otitis media with cholesteatoma is statistically significant ( p < 0.05). Conclusion Although incus is the most common of destructed ossicles in chronic otitis media, facial canal destruction is more closely related to stapes erosion.

Relationship Between Ossicular Chain Erosion and Facial Canal Dehiscence in Chronic Otitis Media Squamous

“…Some authors strongly support that stapes erosion is closely associated with the facial canal dehiscence. 6,10,17,18 Our study also had a similar finding with erosion of stapes significantly associated to the facial canal dehiscence. In order to further analyze the finding, the regression analysis was done which supported our results with the adjusted odds ratio of 3.216 (1.235-8.374).…”

“…Facial canal dehiscence may be congenital due to lack of ossification of the bony canal or may arise from resorptive osteitis secondary to cholesteatoma. 10 The prevalence of facial canal dehiscence is wide, ranging from 0.5% to 74%. Interestingly its dehiscence has been reported higher in histologic studies than in operative cases due to the destruction of the bony covering of the facial nerve during processing or preparation of specimen.…”

The effect of preserved stapedial superstructure on hearing improvement

“…above findings emphasize the crucial role of proper diagnosis and thorough eligibility assessment before performing elective surgery [5][6][7][8][9]. At the same time, they indicate that with less advanced ossicular pathology, the air-bone gap is not always an accurate predictor of expected postoperative hearing improvement, which is a novel finding.…”

“…If severe damage to ossicular chain is found intraoperatively, with only stapes preserved, and in particular if stapedial superstructure is also damaged, a single-stage reconstruction does not offer satisfactory effect [6,8,11]. Radical excision of pathological lesions should be a priority in these patients.…”