Clinico-Pathological Changes in Middle Ear Cleft in Chronic Suppurative Otitis Media

Abstract

BACKGROUND Chronic suppurative otitis media has been traditionally defined as a chronic inflammation of the middle ear and mastoid, usually associated with perforation of the tympanic membrane and otorrhoea. Understanding the pathology and pathogenesis of chronic suppurative otitis media is important in predicting the management, prognosis and sequelae of the disease. MATERIALS AND METHODS The present study was a cross-sectional study that was conducted to evaluate the clinical, intraoperative and histopathological changes in the middle ear cleft. 50 patients diagnosed with CSOM, who underwent surgery were taken. The mucosa and granulation tissue were removed along with ossicles wherever indicated and sent for histopathological examination. RESULTS Incidence of CSOM is highest in 3 rd decade of age with more prevalence in lower socioeconomic group. Females were involved more than males. Unilateral involvement was seen in 64% cases. Otorrhoea and diminished hearing was a constant feature among all cases followed by earache (26%), itching (22%), tinnitus (16%), vertigo (10%) and mass in the ear (6%). On otoscopic examination perforation was seen in 42 cases (84%), while retraction pockets were seen in 8 cases (16%), 7 cases had plastered TM (14%), tympanosclerosis was also found in 6 cases (12%), granulations in 2 cases (4%) and polyp was found in 3 cases (6%). On pure tone audiometry testing, 44 patients (88%) had conductive hearing loss and 6 patients (12%) had mixed hearing loss. CONCLUSION Main conclusion drawn from this study is that on clinical examination 38 cases were found to be of tubotympanic type and 12 cases of atticoantral variety. However, intraoperatively, of the tubotympanic cases, 4 were found to be of unsafe type, which was also proven histologically.