Study of Preoperative Indicators of Ossicular Defect in Mucosal Type of Chronic Suppurative Otitis Media.

Corresponding Author:
Dr. Sonali Prabhakar Khadakkar,
#39, Shivaji Housing Society,
Near Shri Chawadeshwari Mandir,
New Subhedar Nagar, Nagpur-440024,
Maharashtra, India.
E-mail: sonalikhadakkar@yahoo.com

ABSTRACT

BACKGROUND

Ossicular defect is although more common in squamosal type of chronic suppurative otitis media, it can also occur in mucosal type of the disease. Its preoperative knowledge not only helps surgeon to plan for ossicular reconstruction in a better way but also to counsel the patient accordingly. We wanted to determine the prevalence of ossicular chain defect and preoperative identification of clinical and audiological factors as indicators of ossicular defects in patients with Mucosal CSOM.

METHODS

This is a hospital based cross sectional study of 2 years. Patients 15 to 60 years of age, having inactive mucosal type of Chronic Suppura­tive Otitis Media, posted for Tympanoplasty were included in the study. Findings on history, clinical, audiological and intraoperative otomicroscopic examination were recorded and analysed.

RESULTS

Ossicular necrosis was noted in 21 (23.33%) of total 90 patients. On statistical analysis, patients of age >30 years (p=0.019, duration of ear discharge >10 years (p=0.003), those having large and subtotal perforation (p<0.001), adhesion of tympanic membrane edges to promontory (p=0.04), incudostapaedial joint area exposure (p=0.01) and air-one gap >40 dB (p <0.001) were found to be statistically significantly associated with ossicular erosion.

CONCLUSIONS

All patients of mucosal type of chronic suppurative otitis media should be assessed in detail so as to get a clue of ossicular defects to be prepared for its repair and will not come as a surprise during surgery.

KEY WORDS

Chronic Suppurative Otitis Media, Ossicular Necrosis, Air-Bone Gap