A hospital based study of preoperative indicators of ossicular defect in mucosal type of chronic suppurative otitis media

Abstract

Introduction: Chronic otitis media describes chronic middle ear disease and is defined as ‘chronic inflammation of the middle ear and mastoid cavity, which presents with recurrent ear discharge or otorrhoea through a tympanic membrane perforation. There is increased vascularity along with mucosal and submucosal inflammation and thereby increased inflammatory cells within the lamina propria that traverse through the broken basement membrane and enter middle ear lumen. Materials and Methods: This was a Cross Sectional Analytical study conducted in the Department of ENT, Santhiram Medical College and General Hospital, Nandyal from 1st March 2017 to 28th Feb 2019. As it was a time bound study, every consecutive patient of mucosal type of Chronic Suppurative Otitis Media (CSOM) fulfilling inclusion criteria were selected for the study. Patients of either sex and age above 15 years to 60 years having inactive mucosal type of Chronic Suppurative Otitis Media with pure conductive hearing loss and functioning Eustachian tube posted for Tympanoplasty were included in the study. Whereas the patients who were with squamosal type of CSOM and previous history of ear surgery in the same ear were excluded from the study. An informed written consent was taken before the conduct of the study. Results: A total of 90 patients with inactive mucosal type of Chronic Suppurative Otitis Media were included in the study with the mean age of 28.59±10.08 years with male to female ratio of 1:1.8. Out of 90 patients, 21 (23.33%) had ossicular necrosis detected under operating microscope during surgery. Conclusion: The risk of ossicular erosion in mucosal type of CSOM is higher, if the disease persists for >10 years, if the margin of the perforation is adherent to the promontory and if the air-bone Gap is >40 dB. This can help the surgeon to plan for ossicular reconstruction preoperatively.