A Study on Frequency of Ossicular Chain Erosion in CSOM

Aims & Objectives: This study was conducted to find out the hearing restoration surgical treatment in chronic otitis media consists of myringoplasty for drum repair and ossiculoplasty for ossicular defect if present which carries a inferior hit rate and superior chance of revision surgery. Our objective is to evaluate the frequency of ossicular erosion in chronic suppurative otitis media which could be utilized to predict the probability of need for ossiculoplasty preoperatively then patients could be properly consented about these potential issues. Materials and Methods: A prospective study was conducted in the Department of Otolaryngology of Great Eastern Medical School & Hospital Srikakulam in the period from January 2016 to August 2017. 140 ears that underwent surgery for chronic otitis media were studied and their ossicular status was reported. Results: Ossicular chain was eroded in 33 (23.57%) out of the 140 ears. Erosion was more frequent in cholesteatoma ears (66.6%) than in safe ears (13.57%). The most frequently impaired ossicle was the incus and was found eroded in 32 (22.8%) ears. Malleus was found to be the most resilient ossicle and was eroded only in 7 (4.2%) ears. The stapes was eroded in 16 (11.4%) ears. Conclusion: Our study shows that in chronic otitis media, around 30% patients have ossicular chain discontinuity. More than two thirds of patients with cholesteatoma have ossicular chain discontinuity. Otolaryngologists must be capable enough to do ossiculoplasty in ear surgery to provide the finest hearing outcome