Assessment of Ossicular Necrosis in Tubotympanic (Mucosal) Type of Chronic Otitis Media

Abstract

BACKGROUND We wanted to study the preoperative clinical, audiological, radiological findings & compare them with the perioperative findings of ossicular necrosis. METHODS 100 patients were clinically diagnosed as mucosal chronic otitis media (COM). They underwent a thorough clinical, audiological & radiological examination. X-ray mastoid Schuller's view on both sides was done in all patients & HRCT temporal bone was done in 51 patients. They were then posted for surgery & findings were compared with the perioperative ossicular necrosis. RESULTS 42 patients had ossicular defects perioperatively. Incus was found to be the most commonly necrosed ossicle & malleus was the most resistant ossicle. There was a positive association found between duration of disease, posterior perforations, large central & subtotal perforations, polypoidal middle ear mucosa, granulations over margins of perforations & audiological findings with the perioperative ossicular defects. HRCT was the most reliable investigation to predict ossicular necrosis. CONCLUSIONS From the study, it was concluded that all patients with mucosal COM can be assessed preoperatively for ossicular erosion. HRCT gives us a preoperative picture of the extent of ossicular necrosis & helps the surgeon in planning the surgical intervention. KEY WORDS COM, HRCT, Ossicular Necrosis, Mucosal, PTA