Association of Preoperative Audiological and Radiological Ossicular Findings with Peroperative Findings in Patients with Chronic Otitis Media- A Prospective Clinical Study

Abstract

Introduction: Chronic Otitis Media (COM) refers to a chronic infection of mucosa lining the middle ear cleft and is the leading cause of conductive hearing loss in adults. The erosion or disruption of ossicular chain is determined while during the surgery. Complete disruption of ossicular chain can lead up to 60 dB hearing loss. Preoperative High-Resolution Computed Tomography (HRCT) scan of temporal bone can give a clue of ossicular integrity. Aim: To determine the association of preoperative audiological and radiological findings with the peroperative findings in cases of chronic otitis media. Material and Methods: This prospective clinical study was conducted in the Department of Otorhinolaryngology at Subharti Medical College and associated Chhatrapati Shivaji Subharti Hospital, Meerut, Uttar Pradesh, India, from October 2019 to August 2021. Seventy five patients of unilateral uncomplicated chronic otitis media (mucosal or squamosal), with conductive hearing loss, aged between 10 to 50 years were included in the study. Audiological assessment was done in form of pure tone audiometry using Alps 2100 instrument to measure hearing loss in decibels (dB). Radiological assessment was done using bilateral X-ray mastoid Schuller’s view, and HRCT temporal bone. Association of audiological and radiological findings was determined with intraoperative findings using Statistical Package for Social Sciences (SPSS) version 24.0. Results: The mean age of the study population was found to be 26.34±9.14 years. Females 42 (56%) were found to be affected more than males 33 (44%). Significant association was found between severity of hearing loss and necrosed ossicles seen peroperatively as p-value <0.05 in mucosal type of CSOM. Chances of peroperative ossicular necrosis (mucosal) were more in sclerosed (76.47%) and diploic (84.61%) mastoid as compared to pneumatized mastoid (7.69%) with statistically significant difference as p-value<0.01. Maximum accuracy of reporting for HRCT was found for the involvement of part of Incus. Conclusion: There was a significant association of audiological findings and number of ossicles necrosed peroperatively. hence, it can be concluded that greater the degree of hearing loss, more the chances of ossicular necrosis peroperatively.

Keywords

• conductive hearing loss
• ossicles
• pure tone audiometry
• temporal bone