Evaluation of the relashionship between clinical findings before tympanoplasty and ossicular discontinuity and erosion in patients with chronic otitis media

Chronic Otitis Media (COM) is a relatively common condition and the occurrence of hearing loss is probable. COM may lead to ossicular discontinuity, and unless the operation is performed, it wont be determined. Identifying possible cases of erosion and discontinuity of ossicles is helpful in surgical planning and in anticipation of the probable need for procuring ossicular prosthesis.
The aim of this study was to evaluate the relationship between preoperative clinical findings and intraoperative findings.
This is a cross sectional study carried out in 2012 in two tertiary referral hospitals of Tehran, (the Loghman and the Taleghani hospitals). The sample under study consisted of COM patients who referred to the otolaryngology clinics and were tymponoplasty candidates. Two hundred and seven patients with the mean age of 36.2±13.9 (ranging from 9-67 years) were enrolled in the study. Pre-surgical findings were investigated and the relationship between ossicular discontinuity and pre-surgical findings were evaluated.
Incus-Stapes discontinuity (IS Discontinuity) and Incus-Malleus discontinuity (IM Discontinuity) were seen in 60 (29%) and 25 (12.1%) patients, respectively. We found IS Discontinuity in 38 (24.1%) patients with central perforation and 22 (48.9%) cases of marginal perforations (P=0.005). IM Discontinuity was observed in 14 (8.9%) cases with central perforation, while this was seen in 11 (22.4%) cases with marginal perforations (P=0.011). On the other hand, 34 (42%) patients with otorrhea had IS Discontinuity whereas 26 (20.6%) cases of dry ears showed this type of ossicular problem (P Our finding showed that surgical results may be unpleasant in the patients with marginal perforation, otorrhea and ABG>40 db.