Incidence of Ossicular Chain Pathology in Tubotympanic Type of C.S.O.M

Kashyap, Sushil Kumar; Singh, Bhoopendra; Purohit, J. P.; Chandrabhan, Chandrabhan; Singh, Ajay Pratap; Mohd, Azeem

doi:10.14260/jemds/2015/1687

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Although this cannot explained by the known pathogenesis of ossicular necrosis and progression of the disease process, our findings can not be ignored. This also contradicts existing evidences which proves that the presence of tympanosclerosis is associated with ossicular erosion [20]. A multicentric research with larger sample size in the future may throw light on this observation.…”

Section: Discussioncontrasting

confidence: 64%

Pre-operative Indicators of Ossicular Necrosis in Tubotympanic CSOM

Jayakumar

Inbaraj

Pinto

2016

Indian J Otolaryngol Head Neck Surg

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Ossicular necrosis and erosion is commonly seen in CSOM with cholesteatoma but can also occur in tubotympanic CSOM. This usually comes as a surprise during surgery. Preoperative knowledge of ossicular necrosis helps the surgeon to be better prepared for the surgery and ossicular construction if required. Hence, this study is intended to identify the pre-operative indicators of ossicular necrosis. This cross sectional study was conducted in Father Muller Medical College in Mangalore. Sixty nine consecutive patients with tubotympanic CSOM underwent a detailed clinical examination with pure tone audiometry and subsequently tympanoplasty with or without cortical mastoidectomy. All clinical findings, pure-tone audiometry, and intraoperative otomicroscopic observations were recorded. Incidence of ossicular necrosis was 23 %. The incus was most frequently eroded followed by malleus and then stapes. On bivariate analysis patients age above 30 years (p = 0.05), duration of CSOM more than 10 years (p = 0.02), presence of granulation (p \ 0.05), absence of tympanosclerosis (p = 0.01), moderately severe (45-60 dB) hearing loss (p = 0.01) and an air bone gap of more than 55.7 dB in the right ear and 63.95 dB in the left ear was found to be statistically significant (p \ 0.05). On multivariate analysis only presence of middle ear granulation tissue was found to be the significant predicator [(p = 0.005), OR 14.37, 95 % CI 2.26-90.0]. The presence of granulation tissue and a wide air bone gap on pure tone audiometry were the best indicators of ossicular necrosis. Preoperative identification of these indicators can help the surgeon to be better prepared for the surgery.

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Section: Discussioncontrasting

confidence: 64%

Pre-operative Indicators of Ossicular Necrosis in Tubotympanic CSOM

Jayakumar

Inbaraj

Pinto

2016

Indian J Otolaryngol Head Neck Surg

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Ossicular Erosion in Mucosal Type of Chronic Suppurative Otitis Media in Our Experience

Kaliavaradan¹,

Bhat²,

Harish³

et al. 2017

jemds

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BACKGROUNDThe objective of this study was to determine the incidence of ossicular chain erosions in patients suffering from chronic otitis media, mucosal type. MATERIALS AND METHODSThe study group comprised 60 consecutive patients affected by COM, mucosal type. Preoperative assessment was done by thorough clinical examination, pure tone audiometry, X-ray of mastoids, etc. Tympanic membrane perforation, continuity of ossicular chain, condition of middle ear mucosa, condition of mastoid air cells and antrum, patency of aditus was evaluated during surgery. Tympanoplasty and mastoidectomy were performed accordingly. RESULTSOssicular chain erosions were found in 23 (38.33%) out of the 60 patients included in the overall sample. Ossicular chain erosion was found most frequently in subtotal perforation, n=19 (31.67%); in patients with bilateral disease, n=22 (36.67%) and granulation tissue in the middle ear, n=15 (25%). The incus was the ossicle most frequently affected by erosion, n= 20 (33.33%). CONCLUSIONOssicular chain erosions in patients with chronic otitis media, mucosal type are frequent and are present in 38.33% of the patients as per this study. Incus is the most common ossicle to get eroded (33.33%). Subtotal perforation, bilateral disease and granulation tissue in the middle ear can be considered as good indicators of ossicular chain involvement.

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Ossicular Chain Status in Chronic Suppurative Otitis Media Safe Type Undergoing Tympanoplasty

Singh¹,

Agrawal²,

Sahu³

et al. 2018

jebmh

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BACKGROUND The purpose of this prospective study was to evaluate ossicular chain status in safe type of chronic suppurative otitis media. MATERIALS AND METHODS 100 patients who diagnosed and admitted with chronic suppurative otitis media safe type in Dept. of Otorhinolaryngology, CIMS, Bilaspur (CG), from Jan 2016 to Oct 2018 were scheduled for tympanoplasty and per operative findings were noted. RESULTS In our study, we found long process and lenticular process are eroded (8%) and most common ossicles to be eroded were lenticular process of incus and malleus. Stapes was found to be intact. Malleus was most resilient to erosion. CONCLUSION All patients of chronic suppurative otitis media with tubotympanic disease should be checked for ossicular chain continuity and movement of all ossicles should be evaluated to rule out any ossicular erosion and also to rule out tympano-sclerosis involving the ossicular joints.

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Incidence of Ossicular Chain Pathology in Tubotympanic Type of C.S.O.M

Cited by 3 publications

References 5 publications

Pre-operative Indicators of Ossicular Necrosis in Tubotympanic CSOM

Pre-operative Indicators of Ossicular Necrosis in Tubotympanic CSOM

Ossicular Erosion in Mucosal Type of Chronic Suppurative Otitis Media in Our Experience

Ossicular Chain Status in Chronic Suppurative Otitis Media Safe Type Undergoing Tympanoplasty

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