Relation between the duration of disease and audiogram findings in tubotympanic type of chronic suppurative otitis media after myringoplasty

Authors

  • Rajamohan Ganganamoni Department of ENT, RVM Institute of Medical Sciences, Telangana, India
  • Saai Ram Thejas Department of ENT, RVM Institute of Medical Sciences, Telangana, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20205061

Keywords:

CSOM, Myringoplasty, AC threshold, Bone conduction threshold, AB gap

Abstract

Background: Chronic suppurative otitis media (CSOM) has been an important cause of hearing loss and ear discharge in people affected by it for a significant time now. Its prevalence is more in developing countries where the socioeconomic status is low. Poor and overcrowded living conditions, poor hygiene and nutrition have been suggested as a basis for the widespread prevalence of CSOM in developing countries. Pure tone audiometry is the easiest and the most basic procedure which needs to be performed on any patient who has history of hearing loss irrespective of the nature of the disease and the cause surrounding it. Every initial evaluation for CSOM should include audiometric testing via air and bone along with pure tone thresholds. Aim of the study was to co-relate the hearing loss to the duration of the disease in the ear in patients with CSOM and to also associate the same to the corresponding hearing changes after myringoplasty.

Methods: Sixty patients were taken to be part of the study after following a strict inclusion and exclusion criteria. With proper consent, they underwent pure tone audiogram and myringoplasty. Their air bone (AC) gap and air conduction (AC) threshold results were tabulated with the duration of the disease and a consensus was reached at.

Results: It was observed that the hearing loss was much lesser if the duration of the disease was lesser than one year.  As the diagnosis was delayed, both the AB gap and mean AC threshold went up. The early closure of the perforation can significantly bridge the AB gap but the same cannot be said about the AC threshold as it seemed to be lesser affected by the duration.

Conclusions: It can thus be concluded that AC threshold is quietly independent of the changes in the diseased middle ear as compared to the AB gap. This makes it a stronger tool in the assessment of hearing. The early diagnosis and management of tubotympanic type of CSOM can not only help in preventing complications but also aid in better hearing protection which in-turn helps in better social survival.

References

Tos M. Sequelae of secretory otitis media and the relationship to chronic suppurative otitis media. Ann Otol Rhinol Laryngol. 1990;99(146)(4):18-9.

Kraemer MJ, Richardson MA, Weiss NS, Furukawa CT, Shapiro GG, Pierson WE et al. Risk factors for persistent middle-ear effusions. JAMA. 1983;249:1022-5.

World Health Organization. Prevention of hearing impairment from chronic otitis media, Report of a WHO/CIBA Foundation Workshop, held at The CIBA Foundation. World Health Organization, London, U.K. 1996;19-21.

Kenna MA. Epidemiology and natural history of chronic suppurative otitis media. Ann Otol Rhinol LaryngoI. 1988;97(l3l):8.

Bluestone CD. Current management of Chronic Suppurative Otitis Media in infants and children. Pediatr Infect Dis J. 1988;7(1):SI37-40.

Hirose K, Li SZ, Ohlemiller KK, Ransohoff RM. Systemic lipopolysaccharide induces cochlear inflammation and exacerbates the synergistic ototoxicity of kanamycin and furosemide. J Assoc Res Otolaryngol. 2014;15:555-70.

Fish U. Tympanoplasty, mastoidectomy and stapes surgery. J Laryngol Otol. 1994;39:44-9.

Jalm AF. Chronic otitis media: diagnosis and treatment. Med Clin North Am. 1991;75:1277-91.

Berthold EU. Myringoplastik. Wien Med Blatter. 1878;26:627-39.

Zollner F. Radical operation with special reference to auditory function. Zeitschrist Fur Laryngologie Rhinilogie Otologie Und Ihre Grenzgebiete. 1951;30(3):104-11.

Wullstein H. Funktionelle operationen im mittelohr mit hilfe des freien spaltlappen-transplantates. Arch Ohren- Nasen- u Kehlkopfh. 1952;161:422.

Sakagami M, Maeda A, Node M, Sone M, Mishiro Y. Long-term observation on hearing change in patients with chronic Otitis media. Auris Nasus Larynx. 2000;27(2):117-20.

Cusimano F, Cocita VC, D’Amico A. Sensorineural hearing loss in chronic otitis media. J Laryngol Otol. 1989;103:158-63.

Dumich PS, Harner SG, Rochester MN. Cochlear function in chronic otitis media. Laryngoscope. 1983;93:583-6.

Singer AEA, Abdel-Naby Awad OG, El-Kader RMA, Mohamed AR. Risk factors of sensorineural hearing loss in patients with unilateral safe chronic suppurative otitis media. Am J Otolaryngol. 2017;39(2):88-93.

Dawood MR. Hearing evaluation after successful myringoplasty. J Otol. 2017;12(4):192-1.

Thakur G, Kandakure V, Lahane V, Mishra S, Narkhede P . Pre-Operative and Post- Operative Audiometric Evaluation in Chronic Otitis Media. J Dental Med Sci. 2015;14(9):33-5.

Karthikeyan M. A study of hearing improvement after myringoplasty in Chronic Suppurative Otitis Media patients in a tertiary care hospital. MedPulse Int J ENT. 2017;4(3):60-2.

Anderson S. Myringoplasty: A Review of 472 Cases. Ann Otol Rhinol Laryngol. 1980;89(4):331-4.

Lakpathi G, Reddy SL. Comparative study of Endoscope assisted Myringoplasty and Microscopic Myringoplasty. Indian J Otolaryngol Head Neck Surg. 2016;68:185-90.

Downloads

Published

2020-11-24

Issue

Section

Original Research Articles