A Study of the clinical and audiological profile of ossicular status in Attico-Antral type of chronic suppurative otitis media: A prospective observational study
DOI:
https://doi.org/10.51168/1bw34a33Cuvinte cheie:
Chronic Suppurative Otitis Media, Attico-Antral Disease, Cholesteatoma, Ossicular Status, Conductive Hearing Loss.Rezumat
Background
Cholesteatoma has long been a formidable enemy to the otologic surgeon. It is characterized by chronic inflammation of the middle ear cleft. Ossicular necrosis and erosion are commonly associated with it. Preoperative knowledge of ossicular necrosis helps the surgeon to be better prepared for the surgery and ossicular reconstruction if required. It also allows the surgeon to discuss with the patient the possible outcomes of the surgery with respect to hearing improvement. Hence, this study is intended to identify the occurrence of ossicular chain defects in COM and its impact on hearing at the earliest and manage it accordingly.
Objectives: To study the correlation between clinical and audiological evaluation and ossicular defects.
Methods
This is a Prospective study of Ossicular defects in Chronic otitis media- atticoantral type conducted on 50 patients presenting to the Department of Otorhinolaryngology, Navodaya Medical College, Raichur. Since it is a time-bound study, it will be undertaken over a period of 18months.
Results
Otorrhea was the most frequently presenting symptom, being found in 92% of the study population, while hearing difficulty was found in 64% of the study population. On Otoscopic examination, Cholesteatoma was noted in 42% of the patients, while Granulation tissue/polyp was present in 12% of the patients. Hearing impairment was diagnosed in 64% of the patients. Pure tone audiometry revealed that 80% of the study population suffered from Conductive hearing loss, while 20% had mixed hearing loss. This implies that conductive hearing impairment was the most common audiological abnormality associated with attico-antral chronic suppurative otitis media. The results emphasize the importance of detailed otological and audiological evaluation.
Conclusion
In COM, Otorrhea was the most common presenting symptom in our study, followed by hearing loss.
Recommendation
Further studies on a large number of patients with a long follow-up are recommended.
Referințe
1. Slattery WH. Pathology and clinical course of inflammatory diseases of the middle ear. In: Glasscock ME, Gulya AJ, editors. Glasscock-Shambaugh surgery of the ear. 5th ed. New Delhi: Reed Elsevier India Pvt Ltd; 2003. p428-429.
2. Mills RP. Management of chronic suppurative otitis media. In: Booth JB, Kerr AG, editors. Scott-Brown's otolaryngology, vol. 3. 6th ed. London: Reed educational and professional publishing limited; 1997. p1-11.
3. Browning GG, Merchant SN, Kelly G, Swan LRC, Canter R, McKerrow WS. Chronic otitis media. In: Gleeson M, Browning GG, Burton MJ, Clarke R, Hibbert J, Jones NS, et al., editors. Scott-Brown's otorhinolaryngology head and neck surgery, vol. 3. 7th ed. Great Britain: Hodder Arnold; 2008. p3397-3431. https://doi.org/10.1201/b15118-279
4. Chole RA, Sudhoff HH. Chronic Otitis Media, Mastoiditis, and Petrositis. In: Niparko JK, editors. Cummings Otolaryngology Head and Neck Surgery. 5th ed. Elsevier Mosby; 2010. p1963-78. https://doi.org/10.1016/B978-0-323-05283-2.00140-3
5. Abramson M et al. Cholesteatoma pathogenesis: evidence for the migration theory. In: McCabe B, Sade J, Abramson M, editors. Cholesteatoma. First International Conference. Aesculapis: Birmingham; 1977. p176-86.
6. 6) Maroun T, Semaan, Cliff A. Megerian. The pathophysiology of cholesteatoma. Otolaryngol Clin N Am. 2006;39:1143-1159. https://doi.org/10.1016/j.otc.2006.08.003 PMid:17097438
7. Jung JY, Pashia ME, Nishimoto YS, Faddis BT, Chole RA. A possible role for nitric oxide in osteoclastogenesis associated with cholesteatoma. Otolaryngology & Neurotology. 2004;25(5):661-668. https://doi.org/10.1097/00129492-200409000-00003 PMid:15353992
8. Kemppainen HO, Puhakka HJ, Laippala PJ, et al. Epidemiology and aetiology of middle ear cholesteatoma. Acta Otolaryngol(stockh) 1999;119:568-72. https://doi.org/10.1080/00016489950180801 PMid:10478597
9. Telian AS, Schmalbach CE. Chronic otitis media. In: Snow Jr JB, Ballenger JJ, editors. Ballenger's Otorhinolaryngology Head and Neck Surgery. 16th ed. Hamilton, Ontario: BC Decker; 2003. p261-90.
10. Alireza Karimi-Yazdi, Babak Saedi, Mojtaba Fayezizadeh, Hamidreza Seifmanesh. Association between audiometric profile and intraoperative findings in patients with chronic suppurative otitis media. Iranian Journal of Otorhinolaryngology. 2011;23(2):37-42.
11. Kotzias SA, Seerig MM, Mello MF, Chueiri L, Jacques J, Silva MB, Zatt DB. Ossicular chain reconstruction in chronic otitis media: hearing results and analysis of prognostic factors. Brazilian journal of otorhinolaryngology. 2020 Mar 30;86(1):49-55. https://doi.org/10.1016/j.bjorl.2018.09.005 PMid:30545783 PMCid:PMC9422474
12. Doddamani SS, Yasha C. Hearing loss and ossicular status in cholesteatoma. Int J Otorhinolaryngol Head Neck Surg. 2018 Jul;4:1072-5. https://doi.org/10.18203/issn.2454-5929.ijohns20182716
13. Carrillo RJ, Yang NW, Abes GT. Probabilities of ossicular discontinuity in chronic suppurative otitis media using pure-tone audiometry. Otology & Neurotology. 2007 Dec 1;28(8):1034-7. https://doi.org/10.1097/MAO.0b013e31815882a6 PMid:17921908
14. Srinivas C et al.Factors influencing ossicular status in mucosal chronic otitis media − An observational study. Indian journal of otology. 2014;20(1):16-19. https://doi.org/10.4103/0971-7749.129800
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