Verma Ridham B, Kumar Rakesh, Kapadia Parth B, Panchal Ajay J, Sheth Sagar
ENT Department, SMIMER (Surat Municipal Institute of Medical Education & Research) Hospital & Medical College, Near Sahara Darwaja, 3Rd Floor, Bombay Market Road, Umarwada, Surat, Gujarat 395010 India.
Indian J Otolaryngol Head Neck Surg. 2024 Apr;76(2):1563-1568. doi: 10.1007/s12070-023-04360-6. Epub 2023 Dec 13.
The Objective of the study was to assess the ossicular status in chronic otitis media (COM)-mucosal and squamosal type and statistically evaluate the extent of ossicular destruction intraoperatively in COM patients. The findings of this study could help us to predict preoperatively the probability of having ossicular chain destruction in COM ears and thus patients could therefore be properly consented about these potential issues before surgery. The study was carried out in ENT department of tertiary health care hospital, between January 2019 to January 2020. All patients of all age groups and both genders, diagnosed with COM Mucosal and Squamosal Type with complaints of ear discharge and hearing loss with good cochlear reserve and requiring surgery were included in the study, after taking informed written consent in vernacular language. All the patients included in the study were evaluated with detailed history, clinical examination including otomicroscopy, tuning fork tests and pure tone audiometry. The patients were then posted for ear surgery and the middle ear status and ossicular chain status were assessed using a microscope intraoperatively. Out of 98 patients, 45(45.9%) had mucosal and 53 (54.08%) had squamosal disease. Ossicular chain was eroded in 69 cases (70.5%). 23 out of 45 (51.1%) mucosal cases and 46 out of 53 squamosal cases (86.7%) reported ossicular erosion. Most frequently involved was long process of incus > stapes > malleus. From our study, we concluded that there is a significant relationship between type of disease pathology in middle ear and ossicular erosion being higher in Squamosal type of COM, with malleus being the most resistant and incus being the most susceptible ossicle.
本研究的目的是评估慢性中耳炎（COM）黏膜型和鳞状上皮型的听骨状况，并对COM患者术中听骨破坏程度进行统计学评估。本研究的结果有助于我们术前预测COM耳听骨链破坏的可能性，从而在手术前让患者对这些潜在问题有适当的了解。该研究于2019年1月至2020年1月在一家三级医疗保健医院的耳鼻喉科进行。所有年龄组和性别的患者，经诊断为COM黏膜型和鳞状上皮型，有耳漏和听力损失主诉，耳蜗储备良好且需要手术，在获得当地语言的知情书面同意后纳入研究。所有纳入研究的患者均接受了详细的病史询问、包括耳显微镜检查、音叉试验和纯音听力测定在内的临床检查。然后患者被安排进行耳部手术，并在术中使用显微镜评估中耳状况和听骨链状况。98例患者中，45例（45.9%）为黏膜型，53例（54.08%）为鳞状上皮型。69例（70.5%）听骨链受到侵蚀。45例黏膜型病例中有23例（51.1%）、53例鳞状上皮型病例中有46例（86.7%）出现听骨侵蚀。最常受累的是砧骨长突＞镫骨＞锤骨。从我们的研究中，我们得出结论，中耳疾病病理类型与COM鳞状上皮型中听骨侵蚀程度较高之间存在显著关系，锤骨是最具抵抗力的听骨，而砧骨是最易受影响的听骨。
