Eftekharian Kourosh, Eftekharian Ali, Mokhtarinejad Farhad, Amizadeh Maryam, Ghobadi Abolfazl, Saeedi Masoumeh, Sahraiyan Sepehr
Clinical research development unit of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, USA.
Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5725-5730. doi: 10.1007/s12070-024-05073-0. Epub 2024 Sep 12.
To evaluate the opposite ear in patients operated for chronic otitis media (COM). In a cross-sectional study involving three tertiary hospitals, patients who underwent surgery for COM were examined for abnormalities of the contralateral ear at the time of the surgery. Out of 228 patients, 182 (79.8%) were operated on for non-cholesteatomatous or simple chronic pars tensa perforation of the tympanic membrane (PTP), and 46 (20.2%) for cholesteatoma. 113 (49.56%) patients had normal contralateral ears under oto-microscopic exam. PTP was statistically more prevalent in females than males (F/M:118/64), whereas cholesteatoma was more prevalent in males (21/25). In the PTP group, 82 (45.3%) had normal contralateral ears, whereas patients with cholesteatoma had 31 (67.4%) normal opposite ears ( = 0.01). The most frequent abnormal findings in the PTP group were pars tensa perforation and sclerotic plaques, and in the cholesteatoma group were cholesteatoma and pars tensa perforation. Patients with cholesteatoma had significantly lower contralateral ear perforation than patients with tympanic membrane perforation ( = 0.02). The most frequent size of eardrum perforation in the contralateral ear of the PTP group was more than 50 percent. No significant difference existed between the large and small perforations for contralateral abnormality. Bilateral pathophysiology seems to be more prominent in PTPs than in cholesteatomas. Tympanic membrane perforation tends to be accompanied by a large perforation. The larger perforation on one side did not predict having more problems on the opposite side.
评估慢性中耳炎（COM）手术患者的对侧耳。在一项涉及三家三级医院的横断面研究中，对接受COM手术的患者在手术时检查对侧耳的异常情况。228例患者中，182例（79.8%）因非胆脂瘤性或单纯慢性鼓膜紧张部穿孔（PTP）接受手术，46例（20.2%）因胆脂瘤接受手术。113例（49.56%）患者的对侧耳在耳镜检查下正常。PTP在女性中统计学上比男性更常见（女/男：118/64），而胆脂瘤在男性中更常见（21/25）。在PTP组中，82例（45.3%）对侧耳正常，而胆脂瘤患者中有31例（67.4%）对侧耳正常（P = 0.01）。PTP组最常见的异常发现是鼓膜紧张部穿孔和硬化斑，胆脂瘤组是胆脂瘤和鼓膜紧张部穿孔。胆脂瘤患者的对侧耳穿孔明显低于鼓膜穿孔患者（P = 0.02）。PTP组对侧耳鼓膜穿孔最常见的大小超过50%。对侧异常的大穿孔和小穿孔之间没有显著差异。双侧病理生理学在PTP中似乎比在胆脂瘤中更突出。鼓膜穿孔往往伴有大穿孔。一侧较大的穿孔并不能预测另一侧会有更多问题。
