Ossicular chain status in cases of cholesteatomatous chronic otitis media in eastern Nepal

Abstract

Chronic Suppurative Otitis Media (CSOM) is a leading cause of conductive hearing impairment in adults secondary to the damage of the ear drum and middle ear ossicles induced by chronic inflammation present in the tympanic cavity. Ossicular erosion, a frequent complication of CSOM, may lead to total failure of middle ear mechanism resulting in substantial hearing loss.1 The degree of hearing loss varies with size and position of tympanic membrane defect, status of ossicular chain and presence of middle ear pathology. A B S T R A C T ORIGINAL ARTICLE ASIAN JOURNAL OF MEDICAL SCIENCESBackground: Ossicular erosion and disruption of ossicular chain is a frequent complication of cholesteatomatous chronic otitis media leading to hearing loss. Aims and Objectives: To find out the status of ossicles and ossicular chain in patients of choleasteatomatous chronic otitis media undergoing surgery. Materials and Methods: This is a descriptive, cross sectional study conducted among 52 patients of chronic suppurative otitis media with cholesteatoma undergoing surgery at Biratnagar Eye Hospital, Ear Department over 3 years. In each patient the condition and the integrity of ossicular chain was evaluated in order to determine the presence and site of lesion of each ossicles. The data was analysed and expressed in numbers and percentage. Results: Among 52 cases, 27(51.92%) were male and 25(48.08%) were female. The age range was 16 to 50 years. The mean age was 25.6 years. The commonest age range was of 16-20 years, 21 (40.38%). The chief complaints of the patients were ear discharge seen in 52 (100%) cases and hearing loss in 45 (86.5%) cases. Malleus was found intact in 37 (71.1%) cases and absent in 7(13.5%). Handle erosion was found in 3(5.8%) cases. Head and handle erosion was found in 5(9.6%) cases. Incus was found intact in only 6 (11.5%) cases and absent in 11 (21.2%) cases. Long and lenticular process was eroded in 35(67.3%) cases. Intact suprastructure of Stapes was found in 27(51.92%) cases. Suprastructure erosion was found in 25(48.08%) cases. Intact ossicular chain was found only in 6(11.5%) cases. M+S+ was found in 17(32.7%) cases followed by M+S-in 14(26.9%). M-S+ was found in 4(7.8%) cases. All the ossicles eroded were found in 11(21.1%) cases.