Pre and intraoperative findings of chronic otitis media

Abstract

Chronic otitis media (COM) is still highly prevalent in developing countries and often become main cause of deafness and morbid complication. Appropriate management may decrease the morbidity and mortality rate. The aim of the study are to evaluate preoperative and intraoperative finding among COM patients. A descriptive study was conducted at Mohammad Hoesin Hospital Palembang from April 2015 to April 2018. A secondary data was taken from medical records. A total of 252 patients were included in this study with the highest incidence was at 21-30 years old group (29,36 %) with male predominance. The most frequent preoperative assessment were total perforation of tympanic membrane in 104 patients (41.26 %), moderately severe mixed hearing loss in 61 patients (24,2%), and mastoiditis with cholesteatoma in computed tomography (CT) finding in 158 patients (62,69 %). In intraoperative finding, there were 202 patients (80,15%) with cholesteatoma whereas 103 patients (40,87 %) with granulation tissue. Ossicular chain destruction were found in 141 patients (55,95 %). Canal Wall Down Mastoidectomy (CWD) were performed in 190 patients (75,39 %). The prevalence of COM with cholesteatoma at Mohammad Hoesin hospital is still high. Operative management using CWD technique is preferred in cases of COM with cholesteatoma.

Correlation of Tympanomastoidectomy Pathological Findings With Hearing Loss In Chronic Suppurative Otitis Media Patients

“…These results were in line with previous research conducted by Irwan et al. 9 at Dr. Mohammad Hoesin Hospital, Palembang, that out of the 252 CSOM patients, most had mastoiditis with cholesteatoma (62.69%) and 14.28% with sclerotic lesions. The most common HL found in that study were conductive HL (49.98%), followed by sensorineural HL (6.34%).…”

“…The most common HL found in that study were conductive HL (49.98%), followed by sensorineural HL (6.34%). 9 In other studies at the ENT clinic of Government Medical College (GMC) in Amritsar, India, out of 100 CSOM patients accompanied by pathological findings, it was found conductive HL (81%) and mixed HL (19%). 10 More than 50% of CSOM cases had mild to moderate conductive HL.…”

The Compatibility of Preoperative Temporal Bone CT Scan Interpretation and Intraoperative Findings in Chronic Suppurative Otitis Media at Dr. Zainoel Abidin Hospital Banda Aceh

“…There are more safe type CSOM patients than hazard type CSOM with a percentage of 55.6%. Cholesteatoma is a cystic lesion formed by abnormal accumulation of keratinized squamous epithelium in the middle ear, epitympanum, mastoid cavity, petrous apex, or temporal bone [15].…”

“…The bluestone classification further classifies cholesteatoma based on its location and invasion [16,17]. Classification consists of: Stage 1: cholesteatoma confined to the middle ear (hypoepitympanum and mesoepitympanum), without erosion of the ossicular chain; Stage 2: stage 1 with erosion of one or more ossicles; Stage 3: involves the middle ear and mastoid gas cell system without erosion of the auditory ossicles; Stage 4: same as stage 3 but with erosion of one or more ossicles; Stage 5: extensive cholesteatoma of the middle ear, mastoid, and other parts of the temporal bone, whose extent is not fully accessible for surgery (eg, medial to the labyrinth), with one or more ossicles involved with or without a labyrinthine fistula; Stage 6 is the same as stage 5, but the cholesteatoma extends beyond the temporal bone [15,18].…”

“…Abdullah et al reported that the most common finding of ossicular damage was incus damage (87%). Varshney et al reported 85% of the intraoperative findings of CSOM with ossicular damage and 25% were Austin-Kardish type D [15].…”