Contralateral Ear in Chronic Otitis Media: A Histologic Study (original) (raw)
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Contralateral ear findings in chronic otitis media
SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital, 2017
C hronic otitis media (COM) is a major health problem, especially in developing and underdeveloped countries. The chronic nature of the disease can lead to repeated hospital visits and increased financial burden, hearing loss, and related social problems concerning ear discharge, education/learning difficulties, and especially in untreated cases, life-threatening complications. COM is a disease that can affect both ears. Therefore, it is important to know the findings of the contralateral ears other than the affected ears to determine the changes in the tympanic membrane before the onset and during COM in this ear. For this purpose, the data of the patients who were operated on for COM between 2014 and 2017 were reviewed retrospectively. Otoscopic findings, audiologic examinations, and tomography images of the ipsilateral and contralateral ears of the patients were evaluated. Methods In this study, a total of 295 (131 females/164 males) patients who had been operated for the management of COM at the Objectives: Chronic otitis media (COM) reveals a spectrum of otoscopic findings, and both ears may be affected to a different degree. The analysis of contralateral ear in patients with COM is important to detect the early signs of the disease. This may enable the follow-up and treatment of abnormalities in contralateral ear without delay. Therefore, in this study, we aimed to investigate the otoscopic and audiologic findings of contralateral ears of patients with COM. Methods: The institutional data of patients who underwent surgical treatment between 2014 and 2017 due to COM were reviewed. Suppurative ears with cholesteatoma, polyps, and otorrhea refractory to medical treatment and ears with dry middle ear mucosa, with otorrhea responsive to medical treatment, and without cholesteatoma were divided into two groups (Group 1 and Group 2, respectively). All patients were examined with regard to the presence of perforation, retraction, myringosclerosis, atrophy, and audiological results before the groups were compared. Results: Approximately 50% of contralateral ears of patients with COM showed abnormalities at an otoscopic examination in both groups. Tympanic membrane retraction in Group 1 was greater than in Group 2, and the difference was statistically significant (p<0.05). Both the mean air and bone conduction thresholds of the contralateral ears in Group 1 were also found to be elevated when compared with Group 2, and the differences were statistically significant (p<0.05). Conclusion: COM may be seen bilaterally due to the same predisposing factors affecting the ears. Therefore, detection, followup, and early treatment of abnormalities of contralateral ear associated with otitis media have clinical importance in the prevention or delaying progression of these abnormalities to COM.
Chronic otitis media: histopathological changes: a post mortem study on temporal bones
European review for medical and pharmacological sciences
The temporal bones of 4 deceased individuals, with concomitant chronic otitis media are studied. The various histopathological changes in the middle ear cleft are examined: suppuration, polyps, granulation tissue. The possibilities of spontaneous healing of a perforated TM and the indications of surgical treatment are discussed.
Journal of Clinical Medicine
Background: This study focuses on the hearing threshold for bone conduction (BC) after middle-ear surgery. Methods: A total of 92 patients (120 ears) were treated for newly diagnosed chronic otitis media with cholesteatoma (2013–2018). BC was examined at frequencies of 0.5, 1, 2, and 4 kHz prior to and 1 year after surgery. STAM classification for cholesteatoma location, EAONO/JOS for stage, and surgery according to SAMEO-ATO classification were applied. The bone conduction threshold was compared for individual frequencies in patients with occurrence/absence of cholesteatoma in different locations. Results: For the occurrence of cholesteatoma in the attic (A), a statistically significant difference was found at 4 kHz (p < 0.001), in the supratubal recess (S1) at 4 kHz (p = 0.003), and for the mastoid (M) at 0.5 kHz (p = 0.024), at 1 kHz (p = 0.032), and at 2 kHz (p = 0.039). Conclusions: Cholesteatoma location can influence the post-operative hearing threshold for bone conduction.
Relationship between Eustachian Tube Dimensions and Middle Ear Cholesteatoma
ENT Updates, 2020
Objective: To compare intact and diseased ears for Eustachian tube (ET) length and width in patients with unilateral chronic otitis media (COM), and to assess the relationship between cholesteatoma spread, stapes erosion, lateral semicircular canal (LSCC) fistula and ET width and length retrospectively. Methods: Subjects with unilateral COM (122 subjects with 244 ears) who underwent surgery for cholesteatoma were evaluated retrospectively for this study. The width of the distal orifice of the bony segment and the length of the bony segment of the ET for both the diseased and healthy ear were measured. Subjects' healthy and diseased ears were compared for ET length and width. The diseased sides were compared to assess the relationship between ET dimensions and cholesteatoma spread, stapes erosion and LSCC fistula. Results: The mean ET length and width in healthy and diseased ears was 11.38±1.7 and 1.43±0.37 mm, and 10.99±1.6 and 1.27±0.35 mm, respectively; the difference was statistically significant (p<0.001). No significant differences were found in terms of ET length and width between the subjects with and without stapes erosion and LSCC fistula (p=0.765, p=0.573, and p=0.436, p=0.790, respectively). No significant relation was found between cholesteatoma spread and ET length and width (p=0.647). Conclusion: ET dysfunction is frequently associated with COM. Chronic otitis media with cholesteatoma is significantly related to ET length and width. Measurement of ET length and width in CT scans is a basic method that can be used in clinical practice.
Is Cholesteatoma a Risk Factor for Graft Success Rate in Chronic Otitis Media Surgery?
Iranian Journal of Otorhinolaryngology, 2015
Introduction: In developing countries, chronic otitis media (COM) and cholesteatoma are relatively prevalent. Within the field of otology, COM surgery remains one of the most common surgical treatments. Most recent studies evaluating the potential prognostic factors in COM surgery have addressed graft success rate and types of middle ear and mastoid pathology. There has been much controversy about this issue until the present time. This study evaluated the effect of cholesteatoma on the GSR in COM surgery. Materials and Methods: The present retrospective, case-controlled study investigated 422 ears undergoing COM surgery. The minimum and maximum postoperative follow-up periods were 6 and 48 months, respectively. The study group consisted of patients with cholesteatomatous COM, while the control group included patients with non-cholesteatomatous COM, who had undergone ear surgery. Postoperative graft success rate and audiological test results were recorded and the effect of cholestea...
Functional outcomes of middle ear cholesteatoma surgery
Medical review, 2018
Introduction. Chronic otitis media is defined as a persistent inflammation of the middle ear with signs of an infection lasting for three months or longer. Chronic otitis media may occur either with or without cholesteatoma. For both types of conditions, surgical treatment with closed canal wall-up or open canal wall-down techniques of tympanoplasty are considered. Our aim was to evaluate functional outcomes in two groups of patients (chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma) treated with various tympanoplasty techniques. Material and Methods. This retrospective study included 100 patients who underwent canal wall-down and canal wall-up tympanoplasty for the treatment of chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma from 2015 to 2016. All study patients underwent routine clinical and audiometric examinations. The study evaluated preoperative and postoperative functional results (evaluation of pure...
The Journal of International Advanced Otology, 2019
INTRODUCTION Conductive hearing loss is a major symptom of chronic otitis media. The perforation of the tympanic membrane itself causes only a mild hearing loss, but ossicular chain (OC) lesion significantly worsens the hearing threshold. OC involvement is more common in cholesteatoma, but its prevalence in chronic suppurative otitis media (CSOM) without cholesteatoma can also be estimated even up to 33% [1]. Since >300 million individuals are estimated to suffer from CSOM worldwide, of which the majority reports a significant hearing loss [2] , the detection and surgical management of lesions of the OC are crucial to improve the quality of life for such patients. The incus is the most frequently affected ossicle; however, the stapes and the malleus can be involved solely or in combination as well [3, 4]. The usual sequel of inflammation is necrosis, especially at the incudostapedial joint, on the lenticular process and the distal part of the long process of the incus, but destruction of the stapes superstructure or, rarely, of the malleus handle can also occur. In addition to necrosis, immobility of the ossicles due to adhesions, bony fixation, or tympanosclerosis as the end stage of the inflammatory process is also a possible intraoperative finding [5]. In contrast to the evaluation of the destruction of the ossicles,
International Archives of Otorhinolaryngology, 2020
Introduction Chronic otitis media (COM) with a central perforation or a concomitant cholesteatoma are both inflammatory lesions, however, with different etiologies. Both entities may present with an intact chain, and the final reconstruction is quite similar. Does it also apply for the hearing outcome? Objectives In a retrospective analysis, we investigated the preoperative hearing and the final hearing outcome of two groups of patients: those with COM and those with cholesteatoma, and compared various factors. Methods Patients operated between 2010 and 2019 were entered prospectively into a research database, and the integrity of the ossicular chain, the extent of the cholesteatoma, and the findings on computed tomography (CT) scans were retrospectively analyzed and correlated to the final hearing outcome. Results Out of 210 tympanoplasties for COM, 162 (80%) presented with an intact chain, and 85 (40%) ears could be analyzed. Out of 283 cholesteatoma surgeries, 53 (19%) ears prese...